The Interplay between Dysglycaemia and Autonomic Function

Diabetes is associated with a number of comorbidities. Diabetic neuropathy and more specifically diabetic autonomic neuropathy have a high prevalence in both type 1 and type 2 diabetes patients. The impaired autonomic control of the cardiovascular system has several clinical manifestations, including resting tachycardia, orthostatic hypotension, an increased risk of cardiovascular events and severe hypoglycaemia. In addition to hypoglycaemia, hyperglycaemia is also associated with cardiovascular autonomic neuropathy. In this review, we want to highlight the interaction between autonomic dysfunction on the one hand and hypo- and hyperglycaemia on the other. We further summarise assessment methods and outline treatment options for cardiovascular autonomic neuropathy.