**6. Concluding remarks**

Several studies have evaluated the predictive value of various cardiac autonomic neuropa‐ thy parameters for all cause mortality and/or cardiovascular mortality and morbidity. They almost all agree that cardiac autonomic dysfunction is associated with a high-risk excess mortality/morbidity in diabetic patients. Toward a general consensus, however, many chal‐ lenges remain to be addressed by the research community. Drawbacks and limitations main‐ ly concern the following features that deserve attention and discussion [76]:


**6.** Identifying in advance the various cardiovascular prognostic factors (how many and which ones?) to reasonably adjust for in the analysis. Risk adjustment is essential to making fair comparisons and first requires strict definition of each specific outcome, particularly in diabetic people provided the complex association of traditional, non-tra‐ ditional and disease-specific risk factors with mortality/morbidity.
