[Autonomic nervous system in diabetes].

Hyperglycemia and hyperinsulinemia have a primary role in determining the early functional and later anatomic changes at the level of the autonomic pathways controlling the circulation, and besides in directly influencing cardiac and vascular cellular targets and feed-back baroreceptor system sensitivity to neurohumoral modulation in patients with diabetes mellitus. The basic mechanisms of dysfunction and damage, and the clinical and prognostic value of diabetic cardiovascular dysautonomia are discussed together with the diagnostic apparatus and the possible therapeutic approaches.