Definition: Autonomic neuropathy occurs when the nerves that control involuntary bodily functions are damaged. This may affect blood pressure, temperature control, digestion, bladder function and even sexual function. The nerve damage interferes with the messages sent between the brain and other organs and areas of the autonomic nervous system, such as the heart, blood vessels and sweat glands. While diabetes is generally the most common cause of autonomic neuropathy, other health conditions even an infection, may be to blame. Some medications also may cause nerve damage.
Symptoms and Treatment: Symptoms vary depending on the nerves affected. They usually develop gradually over years.
Symptoms may include: Constipation (hard stools), Diarrhea (loose stools), Feeling full after only a few bites (early satiety), Nausea after eating, Problems controlling bowel movements, Swallowing problems, Swollen abdomen, Vomiting of undigested food, Abnormal heart rate or rhythm, Blood pressure changes with position and causes dizziness when standing, High blood pressure, Shortness of breath with activity or exercise, Difficulty beginning to urinate, Feeling of incomplete bladder emptying, Leaking urine, Sexual problems including erection problems in men and vaginal dryness and orgasm difficulties in women, Small pupil in one eye, Weight loss without trying. Treatment to reverse nerve damage is most often not possible. As a result, treatment and self-care are focused on managing your symptoms and preventing further problems. Doctor may recommend: Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels, Fludrocortisone or similar medications to help your body retain salt and fluid, Medicines to treat irregular heart rhythms, Pacemaker, Sleeping with the head raised, Wearing elastic stockings.
Statistics: Statistical analysis in Finland were analysed as study of 120 patients with DM and no previous CVD found evidence that CAN (detected using the Valsalva manoeuvre, the deep breath test and lying-to-standing HRV) was a better predictor of major cardiac events [i.e., myocardial infarction or myocardial infarction (MI)] than the presence of silent ischaemia (OR = 4.16, 95%CI: 1.01-17.19) but when CAN was combined with silent ischaemia the risk was even higher (5 out of 10 had a major event). A study from Spain that included 217 patients with T1DM and T2DM, found that the presence of autonomic neuropathy is independently associated with increased risk for developing silent ischaemia (as demonstrated by positive exercise test) (OR = 6.5, 95%CI: 1.3-7.9) especially when combined with other cardiovascular risk factors such as microalbuminuria.