Although there is considerably more data showing an association between type 2 diabetes mellitus (T2DM) and autonomic neuropathy, accumulating evidence indicates that cardiovascular autonomic neuropathy (CAN) is common in persons with impaired glucose tolerance (IGT). Furthermore, CAN may occur early after a metabolic insult and obesity, especially among mean, and seems to play an important role in the early pathogenesis of CAN. Autonomic symptoms are common in subjects with IGT. In addition to defects in CAN, in subjects with IGT, there is impaired sudomotor function and abnormalities of endothelial peripheral vasoreactivity. At the present time, the only interventions that may be effective in preventing or reversing IGT associated autonomic neuropathy are lifestyle improvement. These include a tailored diet and exercise program. Other approaches that may be beneficial include modulation of oxidative stress and improvement of metabolic regulation in subjects with IGT. Interventions are most likely to be effective early in the course of disease and therefore it is extremely important to have early diagnosis of IGT and autonomic neuropathy.

中文翻译：

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糖尿病前期是否存在心脏自主神经病变？

尽管有更多数据显示 2 型糖尿病 (T2DM) 与自主神经病变之间存在关联，但越来越多的证据表明，心血管自主神经病变 (CAN) 在糖耐量受损 (IGT) 患者中很常见。此外，CAN 可能发生在代谢损伤和肥胖后的早期，尤其是在平均水平中，并且似乎在 CAN 的早期发病机制中起重要作用。自主神经症状在 IGT 受试者中很常见。除了 CAN 缺陷外，IGT 患者还存在促汗功能受损和内皮外周血管反应性异常。目前，可能有效预防或逆转 IGT 相关自主神经病变的唯一干预措施是改善生活方式。其中包括量身定制的饮食和锻炼计划。其他可能有益的方法包括调节氧化应激和改善 IGT 受试者的代谢调节。干预措施最有可能在疾病早期有效，因此早期诊断 IGT 和自主神经病变极为重要。