Diabetic Autonomic Neuropathy An Oft Neglected Entity – MM1703
Diabetic autonomic neuropathy (DAN) is common and important but generally under-recognised. DAN is not
a single entity, but an ‘umbrella term’ with broad clinical implications reflecting the diffuse and integral involvement
of the autonomic nervous system with major body organ systems. Cardiac autonomic neuropathy is a particularly
serious manifestation that may be associated with silent myocardial infarction and represents a major risk for
cardiovascular (CV) mortality. Simple inexpensive tests of cardiac autonomic function are markedly underused.
Gastric autonomic neuropathy is not only associated with upper gastrointestinal symptoms but also has impacts on
postprandial blood glucose control. Erectile dysfunction, another manifestation of autonomic neuropathy, is common
in men with diabetes and a marker of disordered CV function.
Modern Medicine – March 2017
