Drug Dosage Diagnostic tests Side effects
Orthostatic hypotension
9-α-fluoro hydrocortisone 0.1 mg titrated to 0.5 to 2.0 mg/day Measure B.P. by active standing test and passive head up tilt testing (HUT)
Measure catecholamines
Ankle edema, hypokalemia, congestive heart failure
Sympathomimetic agents    
Ephedrine 25-50 mg t.i.d. Sympathetic symptoms
Pseudoephedrine 30-60 mg t.i.d.
Phenylpropanolamine 12.5-25 mg t.i.d.
α-agonist  
Midodrine (FDA approved) 2.5-10 mg t.i.d. Anxiety and tachycardia
Clonidine 0.1-0.5 mg Hypotension
Octreotide 0.1-0.5 μg/kg/day Injection site pain and diarrhea
Supplementary therapy like cox-inhibitor, caffeine etc. can be used
Diabetic Gastroparesis
Metoclopramide 10 mg q.i.d. Antroduodenal manometry
Breath test
Magnetic response imaging
Ultrasonography
Gastric emptying study
Electrogastrography
Dystonic reactions, hyperprolactinemia, extrapyramidal symptoms
Erythromycin 250 mg t.i.d. Nausea, vomiting, abdominal pain, antibiotic resistance
Domperidone 10-20 mg t.i.d. Galactorrhea
Bethanechol 20 mg q.i.d. Salivation, blurred vision, abdominal cramps, bladder spasm
Levosulpiride 25 mg t.i.d. Galactorrhea
Botulinum toxin type A ---- ----
Sepiapterin 20 mg.kg b.w.   ----
Diabetic Diarrhea
Elementary diet ---- Sensation tests of anus
Rectal examination of sphincter muscles
Endoscopy examination of GIT
72 hr stool examination-tests for pancreatic enzyme function
----
Pancreatic extracts ---- ----
Antidiarrheal agents ---- ----
Loperamide 2 mg q.i.d. Toxic megacolon
Anion exchange resin    
Cholestyramine 4 g 1-6 times/ day ----
Long acting somatostatin    
Octreotide acetate 50 μg t.i.d. Aggravated nutrient malabsorption
Metronidazole 250 mg t.i.d. Fungal overgrowth
α2-receptor agonist    
Clonidine.HCl 0.1 mg t.i.d. Orthostatic hypotension
Gastrokinetics and anticholinergics    
Aclatonium napadisilate    
Trimebutine maleate    
Tiquizium bromide    
Cispride    
Macrolides    
EM523L i/v infusion  
Cystopathy
Bethanechol 10  mg q.i.d. Cystometrogram
Postvoiding sonography
Salivation, blurred vision, abdominal cramps, bladder spasm
Doxazosin 1-2 mg t.i.d. Hypotension, headache, palpitations
Erectile Dysfunction
Sildenafil 50 mg o.d., 1 hr. before sexual activity Ultrasound
Urinalysis
Blood test to check testosterone level
Overnight erection test
Headache, flushing, nasal congestion, dyspepsia, muscular skeletal pain, blurred vision
Vardenafil Up to 20 mg/day, 1 hr. before sexual activity
Tadalofil Up to 10 mg/day, 1 hr. before sexual activity
Table 2: Diagnosis and treatment of diabetic autonomic neuropathy