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Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management

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Harvard

Spallone, V, Ziegler, D, Freeman, R, Bernardi, L, Frontoni, S, Pop-Busui, R, Stevens, M, Kempler, P, Hilsted, J, Tesfaye, S, Low, P, Valensi, P & on behalf of the Toronto Consensus Panel on Diabetic Neuropathy* 2011, 'Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management', Diabetes - Metabolism: Research and Reviews (Print Edition), vol. 27, no. 7, pp. 639-53. https://doi.org/10.1002/dmrr.1239

APA

Spallone, V., Ziegler, D., Freeman, R., Bernardi, L., Frontoni, S., Pop-Busui, R., Stevens, M., Kempler, P., Hilsted, J., Tesfaye, S., Low, P., Valensi, P., & on behalf of the Toronto Consensus Panel on Diabetic Neuropathy* (2011). Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes - Metabolism: Research and Reviews (Print Edition), 27(7), 639-53. https://doi.org/10.1002/dmrr.1239

CBE

Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, Stevens M, Kempler P, Hilsted J, Tesfaye S, Low P, Valensi P, on behalf of the Toronto Consensus Panel on Diabetic Neuropathy*. 2011. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes - Metabolism: Research and Reviews (Print Edition). 27(7):639-53. https://doi.org/10.1002/dmrr.1239

MLA

Vancouver

Author

Spallone, Vincenza ; Ziegler, Dan ; Freeman, Roy ; Bernardi, Luciano ; Frontoni, Simona ; Pop-Busui, Rodica ; Stevens, Martin ; Kempler, Peter ; Hilsted, Jannik ; Tesfaye, Solomon ; Low, Phillip ; Valensi, Paul ; on behalf of the Toronto Consensus Panel on Diabetic Neuropathy*. / Cardiovascular autonomic neuropathy in diabetes : clinical impact, assessment, diagnosis, and management. In: Diabetes - Metabolism: Research and Reviews (Print Edition). 2011 ; Vol. 27, No. 7. pp. 639-53.

Bibtex

@article{ec3f077ab9c048dd82e2fccea23eb207,
title = "Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management",
abstract = "Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests are required for definite or confirmed CAN; and 3. the presence of orthostatic hypotension (OH), in addition to heart rate test abnormalities, identifies severe or advanced CAN. Progressive stages of CAN are associated with increasingly worse prognosis. CAN assessment is relevant in clinical practice for 1. diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy. Evidence on the cost-effectiveness of CAN testing is lacking. Apart from the preventive role of intensive glycaemic control in type 1 diabetes, recommendations cannot be given for most therapeutic approaches to CAN. Copyright {\textcopyright} 2011 John Wiley & Sons, Ltd.",
author = "Vincenza Spallone and Dan Ziegler and Roy Freeman and Luciano Bernardi and Simona Frontoni and Rodica Pop-Busui and Martin Stevens and Peter Kempler and Jannik Hilsted and Solomon Tesfaye and Phillip Low and Paul Valensi and {on behalf of the Toronto Consensus Panel on Diabetic Neuropathy*}",
note = "Copyright {\textcopyright} 2011 John Wiley & Sons, Ltd.",
year = "2011",
doi = "10.1002/dmrr.1239",
language = "English",
volume = "27",
pages = "639--53",
journal = "Diabetes - Metabolism: Research and Reviews",
issn = "1520-7552",
publisher = "John/Wiley & Sons Ltd",
number = "7",

}

RIS

TY - JOUR

T1 - Cardiovascular autonomic neuropathy in diabetes

T2 - clinical impact, assessment, diagnosis, and management

AU - Spallone, Vincenza

AU - Ziegler, Dan

AU - Freeman, Roy

AU - Bernardi, Luciano

AU - Frontoni, Simona

AU - Pop-Busui, Rodica

AU - Stevens, Martin

AU - Kempler, Peter

AU - Hilsted, Jannik

AU - Tesfaye, Solomon

AU - Low, Phillip

AU - Valensi, Paul

AU - on behalf of the Toronto Consensus Panel on Diabetic Neuropathy

N1 - Copyright © 2011 John Wiley & Sons, Ltd.

PY - 2011

Y1 - 2011

N2 - Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests are required for definite or confirmed CAN; and 3. the presence of orthostatic hypotension (OH), in addition to heart rate test abnormalities, identifies severe or advanced CAN. Progressive stages of CAN are associated with increasingly worse prognosis. CAN assessment is relevant in clinical practice for 1. diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy. Evidence on the cost-effectiveness of CAN testing is lacking. Apart from the preventive role of intensive glycaemic control in type 1 diabetes, recommendations cannot be given for most therapeutic approaches to CAN. Copyright © 2011 John Wiley & Sons, Ltd.

AB - Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests are required for definite or confirmed CAN; and 3. the presence of orthostatic hypotension (OH), in addition to heart rate test abnormalities, identifies severe or advanced CAN. Progressive stages of CAN are associated with increasingly worse prognosis. CAN assessment is relevant in clinical practice for 1. diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy. Evidence on the cost-effectiveness of CAN testing is lacking. Apart from the preventive role of intensive glycaemic control in type 1 diabetes, recommendations cannot be given for most therapeutic approaches to CAN. Copyright © 2011 John Wiley & Sons, Ltd.

U2 - 10.1002/dmrr.1239

DO - 10.1002/dmrr.1239

M3 - Journal article

C2 - 21695768

VL - 27

SP - 639

EP - 653

JO - Diabetes - Metabolism: Research and Reviews

JF - Diabetes - Metabolism: Research and Reviews

SN - 1520-7552

IS - 7

ER -

ID: 34834029