Diabetic Cardiac Autonomic Neuropathy: Do We Have Any Treatment Perspectives?

V.O. Serhiienko, O.O. Serhiienko

Abstract


Cardiac autonomic neuropathy (CAN) is a severe and common complication of diabetes mellitus. Despite its correlation with the increased risk of cardiovascular mortality and with various symptoms and impairments, the significance of CAN cannot be overestimated. Lifestyle modification, intensive glycemic control might prevent development or progression of CAN. Pathogenetic treatment of CAN includes: balanced diet and physical activity; optimization of glycemic control; treatment of dyslipoproteinemia; correction of metabolic abnormalities in myocardium; prevention and treatment of thrombosis; use of aldose reductase inhibitors; application of dihomo-gamma-linolenic acid (DGLA); use of acetyl-L-carnitine, antioxidants, first of all α-lipoic acid (α-LA), administration of ω-3 and ω-6 polyunsaturated fatty acids (PUFA), vasodilators, fat-soluble vitamin B1, aminoguanidine; substitutive therapy with growth factors, in severe cases — treatment of orthostatic hypotension. The promising methods is the use of agents that increase blood flow in vasa vasorum, including analogs of prostacyclin, thromboxane A2 blockers, and the drugs that contribute to the strengthening and/or normalization in the function of Na+-,K+-ATPase (phosphodiesterase inhibitor), α-LA, DGLA, ω-3 PUFAs, as well as simultaneous administration of α-LA, ω-3 PUFA and DGLA.


Keywords


diabetes mellitus; cardiac autonomic neuropathy; postural hypotension; treatment

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DOI: https://doi.org/10.22141/2224-1485.1.45.2016.74137

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