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Diabetic autonomic neuropathy

Diabetic autonomic neuropathy

Assessment of cardiovascular and gastrointestinal Herbal Beauty Products complications of diabetes. The Neuropafhy ratio is determined from the Neuropatuy tracings Autonomif calculating the ratio of the autoonomic R-R interval Reviving Quenching Drinks the maneuver reflecting the bradycardic response to blood pressure overshoot to the shortest R-R interval during or shortly after the maneuver reflecting tachycardia as a result of strain. Verrotti A, Loiacono G, Mohn A, Chiarelli F. Autonomic dysfunction and heart rate variability in depression. At least two abnormal cardiovagal results are required for a definite or confirmed diagnosis of CAN.

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Diabetic autonomic neuropathy -

Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Diabetic autonomic neuropathy of the gastrointestinal tract. Formulary drug information for this topic.

No drug references linked in this topic. Find in topic Formulary Print Share. View in. Language Chinese English. Author: Thomas Frieling, MD Section Editors: Nicholas J Talley, MD, PhD David M Nathan, MD Deputy Editor: Shilpa Grover, MD, MPH, AGAF Literature review current through: Jan This topic last updated: Aug 10, Abnormalities of GI function in diabetics are thought to be related, at least in part, to autonomic neuropathy of the enteric nervous system [ 1,2 ].

This topic will review the GI manifestations of diabetic autonomic neuropathy. The other manifestations of diabetic autonomic neuropathy are discussed separately.

See "Diabetic autonomic neuropathy". Upper GI symptoms may be more common in patients with long-term type 1 diabetes mellitus [ 15 ]. However, discordant data have also been reported. Furthermore, studies have not consistently used validated measures of GI symptoms [ 16 ], and differences in prevalence may be due to the attention to recognize the signs and symptoms of gastroenteropathy [ 17,18 ].

To continue reading this article, you must sign in with your personal, hospital, or group practice subscription. Subscribe Sign in. Medications that enable erections.

Drugs such as sildenafil Viagra , vardenafil, tadalafil Cialis and avanafil Stendra can help you achieve and maintain an erection. Possible side effects include low blood pressure, mild headache, flushing, upset stomach and changes in color vision.

If you have a history of heart disease, arrhythmia, stroke or high blood pressure, use these medications with caution.

Also avoid taking these medications if you are taking any type of organic nitrates. Seek immediate medical assistance if you have an erection that lasts longer than four hours.

Autonomic neuropathy can cause heart rate and blood pressure problems. Your health care provider might prescribe:.

Medications to raise your blood pressure. If you feel faint or dizzy when you stand up, your health care provider might suggest medications.

Fludrocortisone helps your body retain salt, which helps regulate your blood pressure. Midodrine Orvaten and droxidopa Northera can help raise blood pressure.

But these drugs can cause high blood pressure when you're lying down. Octreotide Sandostatin can help raise blood pressure in people with diabetes who have low blood pressure after eating, but it can cause some side effects. Pyridostigmine Mestinon may help keep blood pressure stable when standing.

If you sweat too much, your health care provider might prescribe a medication that decreases sweating. Glycopyrrolate Cuvposa, Robinul, others can decrease sweating. Side effects can include diarrhea, dry mouth, urinary retention, blurred vision, changes in heart rate, headache, loss of taste and drowsiness.

Glycopyrrolate can also increase the risk of heat-related illness, such as heatstroke, from a reduced ability to sweat. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Posture changes. Stand up slowly, in stages, to decrease dizziness. Sit with your legs dangling over the side of the bed for a few minutes before getting up. Flex your feet and make fists with your hands for a few seconds before standing up, to increase blood flow. Once standing, try tensing your leg muscles while crossing one leg over the other a few times to increase blood pressure.

Several alternative medicine treatments might help people with autonomic neuropathy. Talk with your health care provider about any treatments you want to try.

This can help make sure that they won't interfere with your medical treatments or be harmful. Research suggests this antioxidant might improve the measures of autonomic nerve function. More study is needed.

This therapy involves placing thin needles in specific points in the body. It might help treat slow stomach emptying and erectile dysfunction.

More studies are needed. This therapy sends low-energy electrical waves through electrodes placed on the skin. Some studies have found that it might help ease pain associated with diabetic neuropathy. Living with a chronic condition presents daily challenges.

Here are some suggestions to help you cope:. First, you'll probably see your primary care provider. If you have diabetes, you might see your diabetes doctor endocrinologist. However, you might be referred to a doctor specializing in nerve disorders neurologist.

You might see other specialists, depending on the part of your body affected by neuropathy, such as a cardiologist for blood pressure or heart rate problems or a gastroenterologist for digestive difficulties. Ask if you should do anything before your appointment, such as fasting before certain tests.

Make a list of:. Take a friend or family member with you to help you remember the information you receive and to learn how to support you. For example, if you pass out from low blood pressure, people around you need to know what to do. On this page.

Self care. Alternative medicine. Coping and support. Preparing for your appointment. When you have known risk factors for autonomic neuropathy If you have diabetes or another condition that increases your risk of autonomic neuropathy and have symptoms of neuropathy, your health care provider will perform a physical exam and ask about your symptoms.

When you don't have risk factors for autonomic neuropathy If you have symptoms of autonomic neuropathy but no risk factors, the diagnosis can be more involved. Your provider might recommend tests to evaluate autonomic functions, including: Autonomic function tests.

These tests measure how your heart rate and blood pressure respond during exercises such as deep breathing and forcefully breathing out Valsalva maneuver. Gastrointestinal tests. Gastric-emptying tests are the most common tests to check for digestive issues such as slow digestion and delayed emptying of the stomach gastroparesis.

These tests are usually done by a doctor who specializes in digestive disorders gastroenterologist. Quantitative sudomotor axon reflex test. This test checks how the nerves that manage your sweat glands respond to stimulation.

A small electrical current passes through capsules placed on your forearm, upper and lower leg, and foot. A computer analyzes the response of your nerves and sweat glands. You might feel warmth or a tingling sensation during the test. Thermoregulatory sweat test. You're coated with a powder that changes color when you sweat.

While you lie in a chamber with a slowly increasing temperature, digital photos document the results as you begin to sweat. Your sweat pattern might help confirm a diagnosis of autonomic neuropathy or suggest other causes for decreased or increased sweating.

Urinalysis and bladder function urodynamic tests. If you have bladder or urinary signs and symptoms, a series of urine and bladder tests can evaluate bladder function.

If you have bladder signs and symptoms, your provider might recommend an ultrasound of your urinary tract. In this test, high-frequency sound waves create an image of the bladder and other parts of the urinary tract.

More Information. Tilt table test. Treatment of autonomic neuropathy includes: Treating the underlying disease. The first goal of treating autonomic neuropathy is to manage the disease or condition damaging your nerves.

If diabetes is causing your nerve damage, you'll need to tightly control blood sugar to prevent damage from progressing. About half of the time, no underlying cause for autonomic neuropathy is found.

Managing specific symptoms. Some treatments can relieve the symptoms of autonomic neuropathy. Treatment is based on what part of your body is most affected by nerve damage. Digestive gastrointestinal symptoms Your health care provider may recommend: Diet changes.

You might need more dietary fiber and fluids. Fiber supplements, such as Metamucil or Citrucel, also might help. Slowly increase the amount of fiber you get to avoid gas and bloating.

Medication to help your stomach empty. A prescription drug called metoclopramide Reglan helps your stomach empty faster by increasing the contractions of the digestive tract. This medication can cause drowsiness and shouldn't be used for longer than 12 weeks.

Medications to ease constipation. Laxatives that you can buy without a prescription can help ease constipation. Ask your health care provider how often you should use a laxative. Medications to ease diarrhea. Antibiotics can help treat diarrhea by preventing too much bacterial growth in the intestines.

Anti-diarrheal medication available without a prescription might be helpful. Urinary symptoms Your health care provider may suggest: Retraining your bladder.

Following a schedule of when to drink fluids and when to urinate can help increase your bladder's capacity and retrain your bladder to empty completely at the appropriate times. Medication to manage bladder symptoms. Your health care provider may prescribe medications that decrease an overactive bladder.

Other medications may help empty your bladder. Urinary assistance catheterization. A tube is guided through your urethra to empty your bladder. Sexual dysfunction For men with erectile dysfunction, health care providers might recommend: Medications that enable erections. External vacuum pump. This device helps pull blood into the penis using a hand pump.

A tension ring helps keep the blood in place, maintaining the erection for up to 30 minutes. For women with sexual symptoms, health care providers might recommend: Vaginal lubricants to decrease dryness and make sexual intercourse more comfortable and enjoyable.

One of a few medications approved for premenopausal women with low sexual desire. Heart rhythm and blood pressure symptoms Autonomic neuropathy can cause heart rate and blood pressure problems.

Your health care provider might prescribe: A high-salt, high-fluid diet. If your blood pressure drops when you stand up, a diet that is high in salt and fluid can help maintain your blood pressure. This treatment can cause high blood pressure or swelling of the feet, ankles or legs.

So it is generally recommended only for severe cases of blood pressure problems. And this treatment shouldn't be used in people with heart failure. Compression garments. A binder worn around the waist or thigh-high compression stockings may help improve blood flow. Medication to regulate your heart rate.

A class of medications called beta blockers helps regulate your heart rate if it goes too high during physical activity. Sweating If you sweat too much, your health care provider might prescribe a medication that decreases sweating. Request an appointment. Clinical trials. Elevate the bed.

If you have low blood pressure, it might help to raise the head of your bed by about 4 inches 10 centimeters. You can do this by placing blocks or risers under the legs at the head of the bed.

Aaron I. Vinik Diabetic autonomic neuropathy, Raelene E. NeruopathyBraxton Nruropathy. MitchellRoy Freeman; Diabetic Autonomic Neuropathy. Diabetes Care 1 May ; 26 5 : — Diabetic autonomic neuropathy DAN is a serious and common complication of diabetes. Diabetic autonomic neuropathy

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