Diabetes increases the risk of cardiovascular complications, including heart failure, hypertension, and stroke. There is a strong involvement of autonomic dysfunction in individuals with diabetes that exhibit clinical manifestations of cardiovascular diseases (CVD). Still, the mechanisms by which diabetes and its treatments alter autonomic function and subsequently affect cardiovascular complications remain elusive. For this reason, understanding the brainstem circuits involved in sensing metabolic state(s) and enacting autonomic control of the cardiovascular system are important to develop more comprehensive therapies for individuals with diabetes at increased risk for CVD. We review how autonomic nervous system circuits change during these disease states and discuss their potential role in current pharmacotherapies that target diabetic states. Overall, this review proposes that the brainstem circuits provide an integrative sensorimotor network capable of responding to metabolic cues to regulate cardiovascular function and this network is modified by, and in turn affects, diabetes-induced CVD and its treatment.

糖尿病会增加心血管并发症的风险，包括心力衰竭、高血压和中风。具有心血管疾病 (CVD) 临床表现的糖尿病患者与自主神经功能障碍密切相关。尽管如此，糖尿病及其治疗改变自主神经功能并随后影响心血管并发症的机制仍然难以捉摸。因此，了解参与感知代谢状态和对心血管系统进行自主控制的脑干回路对于为患有 CVD 风险增加的糖尿病患者开发更全面的治疗方法很重要。我们回顾了自主神经系统回路在这些疾病状态期间如何变化，并讨论了它们在当前针对糖尿病状态的药物疗法中的潜在作用。