Autonomic Neuropathy

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Autonomic Neuropathy
July 2006
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Autonomic neuropathy

• Session outline
• Definition and prevalence.
• Contributing factors.
• How is it manifested.
• Treatment and management.

3
Definition and prevalence

• Diabetic autonomic nerve damage may involve
  virtually any sympathetic or parasympathetic
  autonomic function.
• Up to 40 of people with diabetes show some
  evidence of autonomic dysfunction, however, only
  a few have obvious symptoms.

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Contributing factors

• Had diabetes a long time - (the frequency and
  severity of neuropathy increases with the
  duration of diabetes).
• Had high blood glucose levels for a long time.

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How is it manifested

• Cardiovascular manifestations.
• Postural hypotension.
• Gastrointestinal (gastroparesis) - weak or slow
  digestive system.
• Bladder.
• Sexual function.
• Unaware of low blood glucose.

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Cardiovascular

• Resting tachycardia (loss of parasympathetic
  function).
• Postural hypotension (loss of sympathetic
  function).
• Silent M.I. (heart attack).

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Gastrointestinal

• Gastroparesis
• Delayed gastric emptying
• Nocturnal diarrhoea
• Constipation
• Hypoglycaemia

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Urogenital

• Bladder function.
• Erectile dysfunction.

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Hypoglycaemic unawareness

• Reduction in symptoms
• Sweating.
• Pallor.
• Tremor.
• Tachycardia.

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Treatment management

• Cardiac.
• Postural hypotension.
• Gastrointestinal.
• Bladder.
• Erectile dysfunction.
• Hypo unawareness.