II. Background
- Subtype of Diabetic Neuropathy
- Affects sympathetic, parasympathetic and enteric nerves
III. Epidemiology
- Most common in >20 years of poor glycemic control
IV. Cardiovascular Autonomic Neuropathy
- Orthostatic Hypotension
- Exercise intolerance
- Syncope
- Prolonged QT interval on Electrocardiogram
- Evaluate Heart Rate variability and stress test
V. Gastrointestinal Autonomic Neuropathy
- Altered bowel habits (Diarrhea or Constipation)
- Gastric atony (Dysphagia, bloating, Nausea)
- Fecal Incontinence
VI. Genitourinary Autonomic Dysfunction
- Bladder dysfunction
-
Sexual Dysfunction
- Erectile Dysfunction
- Loss of libido
- Anorgasmia
- Dyspareunia (associated with Vaginal Dryness)
VII. Miscellaneous autonomic symptoms
- Unaware of hypoglycemic episodes
- Abnormal pupil function
- Sudomotor Neuropathy (Sweat Gland dysfunction)
- Dry, pruritic skin
- Extremity Hair Loss
- Dry, pruritic skin