- Subtype of Diabetic Neuropathy
- Affects sympathetic, parasympathetic and enteric nerves
- Most common in >20 years of poor glycemic control
- Orthostatic Hypotension
- Exercise intolerance
- Syncope
- Prolonged QT interval on Electrocardiogram
- Evaluate Heart Rate variability and stress test
- Altered bowel habits (Diarrhea or Constipation)
- Gastric atony (Dysphagia, bloating, Nausea)
- Fecal Incontinence
- Bladder dysfunction
-
Sexual Dysfunction
- Erectile Dysfunction
- Loss of libido
- Anorgasmia
- Dyspareunia (associated with Vaginal Dryness)
- Unaware of hypoglycemic episodes
- Abnormal pupil function
- Sudomotor Neuropathy (Sweat Gland dysfunction)
- Dry, pruritic skin
- Extremity Hair Loss
- Dry, pruritic skin