Complications of Diabetes

Autonomic Neuropathy

What is autonomic neuropathy

This refers to diabetic neuropathy or nerve damage involving the ‘autonomic nerves’ – these are nerves which supply a range of internal organs.

What are the systems which may be involved?

  • Digestive system - Stomach, Oesophagus (food passage), Bowel
  • Cardiovascular system - Heart, Blood vessels
  • Genitourinary system - Sexual function & bladder
  • Sweat glands

What are the likely symptoms?

  • Stomach – distension, upper abdominal pain, vomiting
  • Bowel – nocturnal diarrhoea, constipation
  • Heart – faintness/ dizziness on standing
  • Bladder – delayed bladder emptying
  • Sexual function – erectile dysfunction
  • Sweat glands – loss of sweating, fissuring/ dry skin
  • Blood vessels – redness of toes, warm swollen feet

How is it diagnosed?

If you have any of these symptoms, talk to your doctor who will arrange for suitable investigations.

What help is available?

The treatment of autonomic neuropathy once established is often difficult and limited to alleviating symptoms.


Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospital Diabetes Service
October 2002