Integrated Cardio-Respiratory Control: Insight in Diabetes.
Autonomic dysfunction is a frequent and relevant complication of diabetes mellitus, as it is associated with increased morbidity and mortality. In addition, it is today considered as predictive of the most severe diabetic complications, like nephropathy and retinopathy. The classical methods of screening are the cardiovascular reflex tests and were originally interpreted as evidence of nerve damage. A more modern approach, based on the integrated control of cardiovascular and respiratory function, reveals that these abnormalities are to a great extent functional, at least in the early stage of the disease, thus suggesting new potential interventions. Therefore, this review aims to go further investigating how the imbalance of the autonomic nervous system is altered and can be influenced in many chronic pathologies through a global view of cardio-respiratory and metabolic interactions and how the same mechanisms are applicable to diabetes.
Folkhälsan Institute of Genetics, Folkhälsan Research Center, University of Helsinki, Helsinki, Finland. lbern1ps@unipv.it.|Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. lbern1ps@unipv.it.|, Villaggio dei Pioppi 2, 27020, Torre d'Isola, Italy. lbern1ps@unipv.it.
Luciano
L
Bernardi
Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, Paris-Nord University, Bondy, France.
Lucio
L
Bianchi
D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D048909:Diabetes Complications / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000503:physiopathology*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology; D012119:Respiration; D020181:Sleep Apnea, Obstructive / Q000209:etiology
Autonomic nervous system; Baroreflex; Cardio-respiratory interactions; Chemoreflex; Diabetic neuropathy; Heart rate variability; Hypoxia
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