Autonomic Neuropathy

By Richard157 Latest Reply 2014-12-27 16:38:15 -0600
Started 2014-12-21 07:47:25 -0600

Autonomic Neuropathy (AN) is more common among diabetics, and is especially common after 25 years of diabetes. Here are the more common symptoms from the Mayo Clinic:

" Dizziness and fainting upon standing caused by a drop in blood pressure.

Urinary problems, including difficulty starting urination, urinary
incontinence and an inability to completely empty your bladder, which
can lead to urinary tract infections.

Sexual difficulties, including problems achieving or maintaining an
erection (erectile dysfunction) or ejaculation problems in men, and
vaginal dryness and difficulties with arousal and orgasm in women.

Difficulty digesting food, due to abnormal digestive function and slow
emptying of the stomach (gastroparesis). This can cause a feeling of
fullness after eating little, loss of appetite, diarrhea,
constipation, abdominal bloating, nausea, vomiting, difficulty
swallowing and heartburn.

Sweating abnormalities, such as excessive or decreased sweating, which
affects the ability to regulate body temperature.
Sluggish pupil reaction, making it difficult to adjust from light to
dark and causing problems with driving at night.

Exercise intolerance, which may occur if your heart rate remains
unchanged instead of appropriately increasing and decreasing in
response to your activity level."

My neurologist diagnosed my AN in 2010 after I had mentioned extreme dizziness in the AM, and my occasionally falling down. My BP was dropping as much as 40 points when standing up in the morning. Cutting my BP med to half doses has helped, but my BP is still irregular in the morning. I have four of the symptoms listed, and they are gradually becoming more pronounced. Gastroparesis is one of the symptoms, but I do not have that problem at the present time. I hope I never do.

Do you have AN, or do you think you do? Feel free to discuss your symptoms, and how you are dealing with them.

18 replies

valentine lady
valentine lady 2014-12-25 10:25:07 -0600 Report

Hi. Richard,
Very glad you posted this discussion. It's very informative and opens ones mind . I have the blood pressure problem already anf more often than not I
can't take my blood pressure medication in the mornings espically.. We have to take my pressure before I can take medication. It has helped the
dizziness. I have BG drops very bad. Unexpected and sudden. I wrote a discussion about it, it's so bad. Aside from those I don't seem to have anyother symtoms. But I''ll keep this always in mind as it ems I'm working

my way that way. Again thanks for the discussion.
Merry Christmas, Valentine Lady

sweetslover 2014-12-26 20:19:28 -0600 Report

My neurologist told me to tighten my stomach muscles before I stand up. It helps in keeping those drops from occurring when you stand up. I've been trying to follow his advise. So far, it's working…when I remember to do it.

lorlee 2014-12-24 14:18:05 -0600 Report

Hi Richard, thanks for sharing this info. I'm glad to hear reducing the BP medication has helped. The dizziness and falling down/syncope can be multifactorial: aging, diabetes, medications, state of hydration, as well as taking into consideration your other health problems. AN is/can be serious and as I understand something that happens after years of having blood sugars that are not "in target". Hypotheses concerning the multiple etiologies of diabetic neuropathy include a metabolic insult to nerve fibers, neurovascular insufficiency, autoimmune damage, and neurohormonal growth factor deficiency. As a result of these factors alone, there ends up being damage to neuronal damage and cell death.

Richard157 2014-12-25 12:32:31 -0600 Report

Hello Lorlee, that is an impressive post. Are you in the medical profession?

lorlee 2014-12-26 14:26:44 -0600 Report

Hi Richard: No I'm not a Dr, this was in an article I was reading. It is unfortunate that there can be so many other things that cloud the diagnosis though. Sounds like you have done a great job considering you have had DM for so many years, so kudos to you!

hjenkins 2014-12-23 04:05:56 -0600 Report

I have all of these except for the exercising, I was diagnosed 2 years ago. They also diagnosed me with syncope, which is dealing with the bp drops and passing out. Before I was diagnosed I was in so much pain and constantly sick, I couldn't eat or keep anything down and I got down to 100 pounds, things have slowly gotten better now that I am getting my sugars under control. I found that as long as I had insulin in my system when I ate and I didn't eat too much or anything too sugary I was ok…i also keep lots of pepto around

Richard157 2014-12-23 08:42:34 -0600 Report

Thanks for the mention of syncope, I had not heard of that. I will research that since I have the dizziness too. My problem improved a lot when I reduced my blood pressure medicine to half dosages. I'm glad that you are doing so much better now. It seems that you have found the right steps to take to have good control. I hope everything continues that way for you.

GabbyPA 2014-12-22 09:03:42 -0600 Report

I don't have these yet, but it's good to see them this way to keep an eye out for them along the way. Body changes are key and we need to pay attention to them.

jayabee52 2014-12-22 06:27:21 -0600 Report

Howdy Richard
A lot of those symptoms are part of my everyday life. However some ot those symptoms may also be part of a different disease as well.

I am unsteady on my feet due to ministrokes I had sometime in late 2015. I have low BP when I am taken off the dialysis machine (sometimes as low as 50 over 25 - yikes!)

It's hard to sweat here in the Las Vegas climate as it is usually so dry that the perspiration evaporates before it forms beads of sweat. One has to be careful to stay hydrated.

I also have digestive troubles but if I have gastro it is intermittent and hasn't bothered me for some time now.

I pray you don't develop gastro either.


Richard157 2014-12-22 08:10:58 -0600 Report

Hello James, it is nice to hear from you. I am sorry to hear about your strokes, and your dialysis treatment. It does seem like you are doing very well despite the problems. I hope that I am not mistaken.

MoeGig 2014-12-21 09:11:39 -0600 Report

Hello Richard. No, not yet anyway. It'll be 50 years next fall as a Type 1. My big problem are the occasional lows I experience usually in the middle of the night. I wake up with a room full of emt's who tell me my BG is in the twenties.

Type1Lou 2014-12-21 18:48:19 -0600 Report

Moe, I have only been dealing with my Type 1 for 38 years. Several years back, I was experiencing many scary low BG's with one in 2010 landing me in the ER and admitted while on vacation in Idaho. I'd been resisting pumping insulin for years, not wanting to be connected 24/7 but in 2011, with increasingly frequent low BG episodes, I decided it might be time. Now I'm kicking myself for having waited so long. Pumping eliminated the really scary lows and has given me better control with less overall insulin. Like Richard, I do dip into the 40's every now and again but I can get myself out of those with no problem by either eating or reducing/suspending my basal insulin delivery. My husband hasn't had to inject me with glucagon since I started pumping in 2011.

MoeGig 2014-12-21 19:28:57 -0600 Report

Thanks for the response. I guess I have to revisit my stubborn stand against pumping.

lorlee 2014-12-27 15:47:21 -0600 Report

Pumps have come a long way: just until recently I thought they only ran rapid insulins in the the pumps, now I know that that accommodate both basal and rapid and some have 2-3 different settings for your variations in work/exercise/diet, etc.

Richard157 2014-12-27 16:38:15 -0600 Report

Pumps do use only rapid insulins, but they provide basal by having the rapid insullin feed very slowly every few minutes 24/7.

Richard157 2014-12-21 09:21:57 -0600 Report

MoeGig, I used to have those lows in the twenties many years ago. Then I started using an insulin pump. Pumping allows me to set variable basal rates throughout the day and night. That has eliminated my terrible lows. I have occasional lows in the 45-60 range, but I am able to take care of those without any help.