Diabetes is a chronic disease that affects millions of people worldwide. It is characterized by high blood sugar levels resulting from the body’s inability to produce or use insulin efficiently.

Over time, uncontrolled diabetes can damage the nerves, leading to a condition called diabetic neuropathy. This can affect various organs and body parts, including the eyes, heart, kidneys, and feet.

Neuropathy can be classified into several types, depending on which part of the nervous system is affected. One of the most dangerous types is autonomous neuropathy.

As the name suggests, it involves the autonomous nervous system, which controls vital functions of the body, such as breathing, digestion, blood pressure, and heart rate.

The Role of the Autonomous Nervous System in the Body

The autonomous nervous system, or ANS, is a part of the nervous system that operates automatically, without conscious effort or control. It consists of two branches: the sympathetic and the parasympathetic nervous systems.

The former is responsible for the body’s “fight or flight” response, while the latter helps the body rest and digest.

The ANS regulates various bodily functions, including:.

Heart rate and blood pressure
Breathing and oxygen intake
Body temperature
Metabolism and energy balance
Salivation and digestive function
Urination and bladder control
Sexual arousal and function
Sweating and skin temperature

How Autonomous Neuropathy Affects Diabetes Patients

Autonomous neuropathy is a complication of diabetes that affects the ANS. It can lead to a variety of symptoms and consequences, some of which can be life-threatening.

The primary cause of autonomous neuropathy is high blood sugar levels, which can damage the nerves that control the ANS. Over time, this can lead to:.

1. Cardiovascular problems

People with autonomous neuropathy may experience problems with heart rate, blood pressure, and circulation.

For example, they may have a rapid or irregular heartbeat, low blood pressure, or orthostatic hypotension (a sudden drop in blood pressure upon standing up). They may also have reduced or altered blood flow to the heart, causing angina (chest pain) and an increased risk of heart attack or stroke.

2. Gastrointestinal problems

The digestive system is also affected by autonomous neuropathy, leading to various GI symptoms. Some common ones include constipation, diarrhea, bloating, nausea, and vomiting.

These symptoms can be severe and chronic, causing malnutrition, dehydration, and weight loss. In some cases, they can also increase the risk of bowel obstruction or perforation.

3. Urinary problems

The urinary system is controlled by the ANS, and its dysfunction can cause urinary problems in patients with autonomous neuropathy. These may include urinary frequency, urgency, incontinence, or retention.

Patients may also have difficulty starting or stopping urine flow, and may be prone to urinary tract infections.

4. Sexual problems

Autonomous neuropathy can also affect sexual arousal, function, and satisfaction. Men may experience erectile dysfunction, while women may have decreased libido, vaginal dryness, or difficulty achieving orgasm.

These symptoms can be frustrating and embarrassing for patients, and may lead to problems in their relationships or mental health.

5. Sweat gland dysfunction

Sweating is an important function that helps regulate body temperature and remove toxins from the body. However, patients with autonomous neuropathy may have reduced or excessive sweating, depending on which glands are affected.

Some may have dry, cracked skin, while others may have profuse sweating that can lead to skin infections, rashes, or odor.

Preventing and Treating Autonomous Neuropathy in Diabetes

Autonomous neuropathy is a serious complication of diabetes that requires prompt diagnosis and management. To prevent or delay its onset, patients should follow a comprehensive diabetes care plan, which includes:.

Maintaining good blood sugar control, as high levels can accelerate nerve damage
Maintaining a healthy weight and lifestyle, as obesity and sedentary habits can worsen neuropathy
Following a balanced and nutrient-dense diet, as malnutrition can exacerbate GI symptoms and other complications
Keeping up with regular check-ups and medical tests, as early detection and treatment can improve outcomes
Taking medications and supplements as prescribed, such as insulin, oral hypoglycemic agents, vitamins, and pain relievers

If autonomous neuropathy has already developed, patients may benefit from various treatments and therapies, depending on their symptoms and severity. Some of these include:.

Medications that improve blood flow, such as ACE inhibitors or angiotensin receptor blockers (ARBs), nitrates, or calcium channel blockers
Medications that regulate heart rate, such as beta-blockers or anti-arrhythmics
Medications that relieve pain, such as opioids or gabapentin
Medications that regulate GI function, such as laxatives or prokinetics
Physical therapy, such as exercises, stretches, or nerve stimulation
Lifestyle changes, such as quitting smoking, reducing alcohol intake, or eating smaller, more frequent meals
Surgery, in severe cases where obstruction or compression of the nerves is present

Conclusion

Autonomous neuropathy is a hidden risk of diabetes that can cause severe and life-changing symptoms.

By understanding its causes, symptoms, and treatments, patients can take steps to prevent or manage this complication, and improve their quality of life. If you or a loved one have diabetes, speak to your healthcare provider about screening for and treating autonomous neuropathy.