J Korean Diabetes.  2018 Sep;19(3):160-167. 10.4093/jkd.2018.19.3.160.

Diagnosis and Management of Diabetic Autonomic Neuropathy

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea. drangelkr@hanmail.net

Abstract

Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, although it is often overlooked. Abnormal autonomic function tests are often found in peoples with diabetic peripheral neuropathy. Autonomic neuropathies affect the autonomic neurons (parasympathetic, sympathetic, or both) and are associated with a variety of site-specific symptoms. The symptoms and signs of DAN should be elicited carefully during the medical history and physical examination. Major clinical manifestations of DAN include hypoglycemia unawareness, resting tachycardia, orthostatic hypotension, gastroparesis, constipation, diarrhea, fecal incontinence, erectile dysfunction, neurogenic bladder, and sudomotor dysfunction with either increased or decreased sweating. When a patient has signs and symptoms of DAN, various autonomic function tests should be performed. Recognition and management of DAN may improve symptoms, reduce sequelae, and improve quality of life. Clinically relevant diabetic autonomic neuropathies such as cardiovascular, gastrointestinal, genitourinary, and sudomotor dysfunction should be considered in the optimal care of patients with diabetes. The present review summarizes the latest knowledge regarding clinical presentation, diagnosis, and management of DAN.

Keyword

Autonomic neuropathy; Diabetic neuropathy

MeSH Terms

Constipation
Diabetic Neuropathies*
Diagnosis*
Diarrhea
Erectile Dysfunction
Fecal Incontinence
Gastroparesis
Humans
Hypoglycemia
Hypotension, Orthostatic
Male
Neurons
Peripheral Nervous System Diseases
Physical Examination
Quality of Life
Sweat
Sweating
Tachycardia
Urinary Bladder, Neurogenic
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error