Diabetes is a chronic disease, and long-term high blood glucose can lead to various complications. Among them, autonomic neuropathy is one of the common diabetic complications, mainly manifested as orthostatic hypotension, cardiac autonomic neuropathy, gastrointestinal symptoms, abnormal urination, abnormal sweating, and so on.
Orthostatic hypotensionDiabetic patients may experience orthostatic hypotension, characterized by dizziness, blurred vision, or even fainting when standing up, squatting down, or rapidly changing posture. This is caused by vascular damage due to prolonged high blood glucose, which reduces vascular elasticity. As a result, blood cannot sufficiently supply the brain promptly during posture changes, leading to insufficient cerebral blood flow.
Cardiac autonomic neuropathyDiabetic autonomic neuropathy may also affect the heart, causing a persistent rapid heart rate, usually above 90 beats per minute, which does not vary with activity or rest. In severe cases, patients may develop coronary heart disease without angina, and even myocardial infarction may present as silent myocardial infarction.
Gastrointestinal manifestationsDiabetic patients may develop gastrointestinal autonomic neuropathy, presenting as fullness, early satiety, bloating, postprandial discomfort, nausea, and upper abdominal pain — a condition known as diabetic gastroparesis. In addition, patients may experience constipation, or alternating constipation and diarrhea.
Abnormal urinationDiabetic patients may have urinary symptoms such as incomplete emptying, weak urination, and even urinary retention, referred to as neurogenic bladder. A small number of patients may develop urinary incontinence. These symptoms are related to nerve damage caused by diabetes.
Abnormal sweatingDiabetic patients may experience excessive sweating on the upper body (including heavy sweating while eating) and reduced or no sweating on the lower body. This abnormal sweating pattern is associated with disordered sweat gland function caused by autonomic neuropathy.