Autonomic neuropathy is a common complication of diabetesthat can manifest in a range of different organ systems. It represents a major source of morbidity, mortality and healthcare use.
- Diabetic autonomic neuropathy (DAN) is common and important but generally under-recognised.
- DAN is not a single entity, but an ‘umbrella term’ with broad clinical implications reflecting the diffuse and integral involvement of the autonomic nervous system with major body organ systems.
- Cardiac autonomic neuropathy is a particularly serious manifestation that may be associated with silent myocardial infarction and represents a major risk for cardiovascular (CV) mortality.
- Simple inexpensive tests of cardiac autonomic function are markedly underused.
- Gastric autonomic neuropathy is not only associated with upper gastrointestinal symptoms but also has impacts on postprandial blood glucose control.
- Erectile dysfunction, another manifestation of autonomic neuropathy, is common in men with diabetes and a marker of disordered CV function.
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