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In patients with long-standing Type 1 diabetes, one of the notable cardiovascular changes is a fixed heart rate due to autonomic neuropathy. This is a complication of diabetes that affects the autonomic nervous system, which is responsible for regulating involuntary functions, including heart rate. Over time, damage to the autonomic nerves can impair the ability of the heart to respond appropriately to physiological stresses such as exercise or changes in body position. As a result, the heart rate may not exhibit the normal variability seen in healthy individuals, particularly in response to physical activity, leading to a more fixed heart rate.

Contrary to this, a higher or lower resting heart rate would typically suggest a different set of cardiovascular conditions or responses, such as training adaptations or acute stress responses, but that is not a hallmark of long-standing diabetic issues. Similarly, a variable heart rate with exercise indicates a preserved autonomic control, which is less commonly observed in individuals with advanced diabetic autonomic neuropathy.