Introduction: Cardiac autonomic neuropathy is a little known and underdiagnosed condition in diabetic patients, characterized by damage to autonomic nerve fibers causing symptoms such as exercise intolerance and postural hypotension; the prevalence and risk factors in the Colombian diabetic population are unclear and understudied.Objective: To determine the prevalence of cardiac autonomic neuropathy and associated factors in diabetic patients in a Colombian population.Materials and method: This was an analytical cross-sectional study, in a population of 107 patients with type I and type II diabetes mellitus who were seen at a secondary care hospital in Colombia between April and September 2022.The diagnosis was made using the Ewing cardiovascular autonomic reflex tests.Descriptive and associative statistical analyses were performed using logistic regression, calculating odds ratios and 95% confidence intervals.Results: The study population had a mean age of 62 years, with 56.1% being women.Altogether, 94.4% (95% CI: 89.9-98.6) of the participants had a positive cardiac autonomic neuropathy test; 6.5% had early involvement, 26.2% had definite involvement and 61.7% had severe involvement; age is associated with the onset of cardiac autonomic neuropathy, aOR: 1.07 (95% CI: 1. 03-1.11).Conclusions: The current study found a high prevalence of cardiac autonomic neuropathy (94.4%) when using the diagnostic gold standard.Patient age was associated with the presence and severity of this disease.