Autonomic diabetic neuropathy: Not painful, but extremely harmful
Nerves can be damaged during diabetes. This diabetic neuropathy is irreversible. The autonomic nervous system can also be affected. / © Getty Images/Kateryna Kon/Science Photo Library
An increased resting heart rate, dyspeptic symptoms, sexual dysfunction, and sweating disorders – all of these can be symptoms of diabetes-related damage to the autonomic nervous system (see box). "These are often shameful symptoms, such as digestive disorders or sexual dysfunction, which the patients themselves do not associate with their diabetes," said Dr. Gidon J. Bönhof of the German Diabetes Center (DDZ) at the University of Düsseldorf at a recent online press conference of the German Diabetes Society (DDG).
Doctors should actively inquire about possible symptoms of autonomic diabetic neuropathy (ADN) among their patients: "We need to raise awareness among both physicians and patients," Bönhof emphasized. ADN is not uncommon: According to a 2021 DDG practice recommendation, one in five patients with diabetes has cardiovascular ADN (DOI: 10.1055/a-1515-9168 ). And ADN is not necessarily a late complication of diabetes: "Many recent studies have shown that autonomic neuropathy can also develop early in the course of the disease," Bönhof said.
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