Diagnosis and Management of Diabetic Autonomic Neuropathy.

Kim,  Chong Hwa

doi:2018.19.3.160

J Korean Diabetes > Volume 19(3); 2018 > Article

Focused Issue

The Journal of Korean Diabetes 2018;19(3):160-167.
DOI: https://doi.org/10.4093/jkd.2018.19.3.160 Published online October 5, 2018.

당뇨병성 자율신경병증의 진단 및 치료

김종화

Diagnosis and Management of Diabetic Autonomic Neuropathy.

Chong Hwa Kim

Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea. drangelkr@hanmail.net

Abstract

Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, although it is often overlooked. Abnormal autonomic function tests are often found in peoples with diabetic peripheral neuropathy. Autonomic neuropathies affect the autonomic neurons (parasympathetic, sympathetic, or both) and are associated with a variety of site-specific symptoms. The symptoms and signs of DAN should be elicited carefully during the medical history and physical examination. Major clinical manifestations of DAN include hypoglycemia unawareness, resting tachycardia, orthostatic hypotension, gastroparesis, constipation, diarrhea, fecal incontinence, erectile dysfunction, neurogenic bladder, and sudomotor dysfunction with either increased or decreased sweating. When a patient has signs and symptoms of DAN, various autonomic function tests should be performed. Recognition and management of DAN may improve symptoms, reduce sequelae, and improve quality of life. Clinically relevant diabetic autonomic neuropathies such as cardiovascular, gastrointestinal, genitourinary, and sudomotor dysfunction should be considered in the optimal care of patients with diabetes. The present review summarizes the latest knowledge regarding clinical presentation, diagnosis, and management of DAN.

Key Words: Autonomic neuropathy, Diabetic neuropathy