Autonomic Neuropathy

Autonomic neuropathy is a very complex nerve disorder and can frequently affect diabetics. Autonomic neuropathy type can effect each and every body system which I will cover here. The symptomatology varies widely. Depending on where this disease is attacking inside the body systems, are the areas where symptoms will clearly show up.


Dizziness and fainting when standing may occur with hypotension, which is low blood pressure.

Sexual difficulty which can include ejaculation problems in men, or erectile dysfunction. Females may be having vaginal dryness and problems with orgasm.

Stomach emptying such as gastroparesis causes the stomach to have a lot of trouble letting go of food eaten, making it difficult to digest. See Gastroparesis article.

Problems with sweat glands which means trouble producing sweat, or else the opposite of producing too much sweat. The reason for this being that the body cannot regulate its temperature.

Eye problems with pupil reaction. This makes it hard for the eyes to adjust from light to dark and problems with driving at night.

Trouble with exercise. The heart rate doesn't change even in aerobic exercise, but stays the same way.

Hypoglycemic unawareness. This is a lack of feeling when the blood sugars are too low, and you do not realize you are low.

One of the main problems with this neuropathy is a diabetic bladder

A diabetic bladder means that the signal you need to empty your bladder fails from the nerves when you have no feelings there anymore. Diabetic neuropathy or bladder damages these nerves of the urinary sphincter. The stream of urine is weakened, and causes a person to be unable to urinate much. Infection of the bladder is therefore very common in this problem, and the only way to solve it is by self-catheterization of the bladder where the bladder can be completely emptied. Drinking a lot of fluids and going to the restroom every 2 hours also helps the problem. Drugs that help this problem are Urecholine or Duvoid. These pills increase the tone of muscle that helps the bladder to empty.

Diagnosing this problem

If it is suspected that you have this nerve disorder, the following tests may be ordered:

Breathing Tests This is to find out how well your heart rate responds to breathing exercises and how the blood pressure does as well.

Gastrointestinal Tests to determine how well your stomach empties or not. This usually means a GI series.

Tilt-Table Test which tells how well your body responds to different positions with blood pressure and heart rate.

QSART Test The QSART test stands for Quantitative sudomotor axon reflex test. It tells the story on how your nerves which are responsible for sweating will respond back when stimulated. They perform this test by a current that is electrical and small, and with capsule types that are placed on the extremeties, you should feel a tingling. The Thermoregulatory Test might also be done which you are powdered with a special powder that changes color. The powder changes color when you sweat. They will place you in a special chamber, increasing temperature. Your temperature will go up at least 1 degree up to 1.5 degrees while there. Photographs are taken while in there to see your body's actual sweating. They can diagnose autonomic neuropathy easily by this test after seeing the sweating pattern, whether normal or abnormal.

A bladder ultrasound may be done to take bladder pictures.

Treating the whole picture of autonomic neuropathy involves what is causing the basic problem. Blood sugar control needs to be kept in tight control, and other durgs for the various problems throughout the body will need to be given.

For stomach trouble, the proper diet may help by adding some fiber-rich foods along with more fluids. Drugs that help stomach emptying also help the person to feel better, and lead a more productive life. One such drug is Reglan, which makes stomach emptying more productive.

For sexual problems drug therapies such as Viagra may hep a man or Levitra. See the page on sexual problems. For heart related problems in autonomic neuropathy, doctors may give a blood pressure pill that regulates your system. Other drugs that help your body keep the right amounts of salt may do a lot.

Medications to control sweating if you have that problem may be given. Drugs such as Clonidine for example, decrease the sweating problems.

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