Duration of diabetes, glycemic control, and low heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study

Persons with long-standing, poorly controlled diabetes or recent hyperglycemia had the highest burden of cardiac autonomic neuropathy. Cardiac autonomic neuropathy contributed to elevated long-term incidence of cardiovascular disease and mortality even in persons with well-controlled diabetes. •Diabetes was independently associated with lower heart rate variability.•Persons with long-standing diabetes had a high burden of cardiac autonomic neuropathy (CAN).•CAN was associated with high risks of complications even in those with well-controlled diabetes.