THE fatal complication of diabetes is autonomic neuropathy which typically leads to a “silent heart attack”. Unfortunately this is not very well known and therefore not very well covered. THIS IS NOT what everybody understands as neuropathy which is really peripheral neuropathy.
According to various studies, autonomic neuropathy affects over 50% of all PWD. In general it leads to 50% mortality 5-10 years after onset. At onset there are NO symptoms. Symptoms appear when one of the organs, in most cases the heart, is affected. By then it is too late.
This is so serious that the ADA has recommended Heart Rate Variability testing (to identify this) in its standards of care since 2006. This testing is supposed to be done immediately upon detection of Type 2 diabetes and 5 years after detection of Type 1 diabetes. It is to be repeated annually if negative. If detected early it is possible to reverse it and reduce/eliminate the risk of cardiovascular disease among PWD.
However, nobody follows this recommendation. One deterrent has been that there really has not been a simple testing method that has allowed this recommendation to be implemented in a clinical setting.
There is one now. I am attaching a link to a booklet that addresses the “detection, monitoring & treatment of diabetic autonomic neuropathy”. This was compiled from the experiences of doctors (mainly in India) on about 100,000 PWD. India is the diabetes capital of the world with over 50 million diabetics.
This can be easily implemented in the US since the products are FDA cleared and the procedures are reimbursable by insurance. It is strange that the US PWD cannot access the same treatment that the Indian PWD now can.
You can obtain a free copy of this booklet by following the link
http://www.dyansys.com/diabetic-autonomic-neuropathy-booklet.php
You need to be very careful to differentiate it from peripheral neuropathy which is completely different.
Thank you for sharing this important information and helping PWD minimize the risk of cardiovascular disease. This will go a long way to helping them lead long, healthy lives.
