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Evolution of symptoms of cardiac autonomic neuropathy (CAN) in diabetes. Patients display reduced variability in heart rate and resting tachycardia in the early phase of parasympathetic dysfunction, which underlie the reduced exercise tolerance and the increased arrhythmogenesis. Later stages of CAN involve sympathetic denervation and cause hemodynamic dysregulation and silent myocardial ischemia. Source: Own authorship.
