Autonomic Neuropathy

If you have diabetes, controlling your blood glucose, or blood sugar, is important to help you feel well on a daily basis. It’s also vital to help prevent potentially serious complications such as nerve damage, or neuropathy.

About half of the estimated 14.7 million people with diabetes eventually develop nerve damage, according to the National Institute of Diabetes and Digestive and Kidney Diseases. When the nerves that control internal organs or involuntary functions, such as breathing or the beating of your heart, are involved, it’s known as autonomic neuropathy. This condition also can affect those with other conditions, including Parkinson’s disease and alcoholism. But, most people with this neuropathy have had diabetes for 25 years or longer. It’s more common in those who’ve had trouble controlling their blood glucose levels, and in those who smoke, are overweight or have high cholesterol and high blood pressure.

Autonomic neuropathy can cause many symptoms. Depending on which nerves are involved, here are some areas of the body it may affect:

• Perception of symptoms. If your blood glucose level is too low, you may start having symptoms such as sweating, shaking and heart palpitations. With nerve damage, you may not know that there’s a problem because you can’t feel these symptoms.

• Urinary tract. Nerve damage may keep your bladder from emptying completely. This may make it easier for bacteria to grow and cause infections. It also may be difficult to tell if your bladder is full or to control urination.

• Sexual organs. Men may be unable to have erections. Women may notice a loss in their sexual response.

• Digestive system. Neuropathy can affect any part of your digestive system. If it involves the stomach, it’s known as gastroparesis. This condition causes food to move slowly out of your stomach, making it difficult to control blood glucose levels.

• Cardiovascular system. Nerve damage interferes with the nerve impulses that tell the heart how fast to beat or when blood pressure needs to rise or fall. So, your heart may beat too fast, your heart rate may not increase when you exercise or decrease when you stop, or your blood pressure may drop, especially when you first stand up.

Tests and treatments

To help make an accurate diagnosis, your doctor will perform a physical exam and take your medical history. You also may be given other tests to help determine how well certain organs are working.

Unfortunately, there’s no way to fix affected nerves. Treatment depends on the disease that caused the neuropathy. If the cause is diabetes, keeping blood glucose levels as close to normal as possible can help prevent future damage. If you do have neuropathy, your doctor may prescribe medications that can help relieve some symptoms.

If you’re having trouble keeping your glucose levels in your target range, ask your doctor for help. He or she can give you practical tips for eating well, getting regular exercise and managing your medications.

Specific medications are available to help the stomach empty faster, and help with sexual problems and urinary incontinence. Talk to your health care provider to see if there is a medication that can help your symptoms.