Diabetic autonomic neuropathy

Abstract

Diabetic neuropathy may affect the nervous system in several ways. Central nervous system involvement does not generally give rise to clinically recognized abnormalities but has been reported in pathological studies (Reske Nielsen et al., 1965). Somatic neuropathy has long been recognized and this article will not discuss the various clinical syndromes listed. Although clinical features, in retrospect attributable to autonomic nerve involvement, were originally described in the late 19th century, it was Rundles in 1945 who first clearly delineated the characteristic symptom complexes of diabetic autonomic neuropathy. Although very little is known regarding the pathological abnormalities in the autonomic nerves, recent years have seen a greater understanding in the abnormal function produced by autonomic neuropathy. The purpose of this article is to review the clinical features of diabetic autonomic neuropathy and to discuss some of the simpler methods now available for assessing autonomic function.