Cardiac autonomic neuropathy: role of metabolic therapy

Neuropathy is one of the most common complications of diabetes mellitus (DM) and affects about 60% of patients. Patients with type 2 DM can have this complication after several years of poor glycemic control, and sometimes these patients already have neuropathy at the time of DM diagnosis. Diabetic autonomic neuropathy (DAN) is a type of diabetic peripheral neuropathy. Whereas, cardiac autonomic neuropathy (CAN) is a type of diabetic autonomic neuropathy and the most commonly form of DAN. It is now known that 50% of patients with DM suffering from diabetic neuropathy have asymptomatic CAN (form of diabetic autonomic neuropathy - DAN), while 100% of patients with symptoms of CAN have classic diabetic neuropathy. Orthostatic hypotension (OH) is a common manifestation of CAN. In general, the prevalence of OH among elderly patients is 54-68% and 6% in the general population. OH is a serious problem primarily because of the impact on the course of chronic somatic diseases. The existence of OH is an independent risk factor for incidence of myocardial infarction (and for mortality as well), stroke, heart failure and arrhythmias. This article deals with Ewing’s five standard tests for diagnosing cardiovascular pathology. This article discusses the possibility of prescribing preparations of a-lipoic acid, vitamin B preparations, preparations containing vitamin B-complex and biologically active substances in the capacity of possible pathogenetic DAN therapy. Cocarnit is a complex preparation, containing vitamins B and metabolically active compounds, which can improve total somatical state of patients with DAN.

diabetes mellitus, diabetic autonomic neuropathy, cardiac autonomic neuropathy, orthostatic hypotension, Cocarnit