Diabetic neuropathy associated complications, which affects
all major organs of the body, are common in Type 1 and Type 2 diabetes. Cardiac
diabetic neuropathy is characterised by damage to nerves regulating the heart
rate and any changes in the capacity of these nerves to modulate heart rate
leads to changes to heart rate variability (HRV).
Its prevalence lies between 20% and 60% in patients with diabetes,
with a mortality that is approximately five times higher.Testing for cardiac
autonomic neuropathy (CAN) in people with diabetes was traditionally based on
five Ewing cardiac reflex tests that constitute the gold standard.
Recent research has been investigating the efficacy of
alternative diagnostic tests, using ECG attributes to address shortcomings of
the Ewing battery as a number of the Ewing tests included in the Ewing battery
are often counter-indicated for patients with cardiorespiratory comorbidity,
frail or severely obese patients.
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