II. Background

  1. Subtype of Diabetic Neuropathy
  2. Affects sympathetic, parasympathetic and enteric nerves

III. Epidemiology

  1. Most common in >20 years of poor glycemic control

IV. Cardiovascular Autonomic Neuropathy

  1. Orthostatic Hypotension
  2. Exercise intolerance
  3. Syncope
  4. Prolonged QT interval on Electrocardiogram
  5. Evaluate Heart Rate variability and stress test

V. Gastrointestinal Autonomic Neuropathy

  1. Altered bowel habits (Diarrhea or Constipation)
  2. Gastric atony (Dysphagia, bloating, Nausea)
  3. Fecal Incontinence

VI. Genitourinary Autonomic Dysfunction

  1. Bladder dysfunction
    1. Urinary Incontinence
    2. Urinary frequency
  2. Sexual Dysfunction
    1. Erectile Dysfunction
    2. Loss of libido
    3. Anorgasmia
    4. Dyspareunia (associated with Vaginal Dryness)

VII. Miscellaneous autonomic symptoms

  1. Unaware of hypoglycemic episodes
  2. Abnormal pupil function
  3. Sudomotor Neuropathy (Sweat Gland dysfunction)
    1. Dry, pruritic skin
      1. Extremity Hair Loss

VIII. Differential Diagnosis

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Ontology: Diabetic Autonomic Neuropathy (C0271686)

Concepts Disease or Syndrome (T047)
MSH D003929
SnomedCT 50620007
Italian Neuropatia autonomica diabetica
English Autonomic neuropathy-diabetes, diabetes mellitus with autonomic neuropathy (diagnosis), diabetes mellitus with autonomic neuropathy, diabetic autonomic neuropathy, Autonomic Neuropathies, Diabetic, Autonomic Neuropathy, Diabetic, Diabetic Autonomic Neuropathies, Neuropathies, Diabetic Autonomic, Neuropathy, Diabetic Autonomic, autonomic diabetic neuropathy, Diabetic autonomic neuropathy, Autonomic neuropathy due to diabetes, Diabetic autonomic neuropathy (disorder), Diabetic Autonomic Neuropathy
Portuguese Neuropatia Autônoma Diabética, Disautonomia diabética
Spanish Neuropatía Autónoma Diabética, neuropatía autonómica diabética (trastorno), neuropatía autonómica diabética, Neuropatía autonómica diabética
French Neuropathie diabétique autonome
German Diabetische autonome Neuropathie, diabetische autonome Neuropathie
Japanese 糖尿病性自律神経ニューロパチー, トウニョウビョウセイジリツシンケイニューロパチー
Czech Diabetická autonomní neuropatie, diabetická autonomní neuropatie
Hungarian Diabeteses autonom neuropathia
Norwegian Diabetisk autonom nevropati
Dutch diabetische autonome neuropathie, Diabetische autonome neuropathie