Diabetic Autonomic Neuropathy

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Abstract
Diabetes commonly causes widespread damage to the peripheral nervous system, involving chiefly the somatic sensory and autonomic nervous systems, although in individual patients the involvement of one system or the other may predominate. Small nerve fibers are probably the first to be affected, leading to early impairment of the sensations of pain and temperature, accompanied by a decline in autonomic function. Measurable autonomic defects are extremely common in diabetes, affecting possibly as many as one sixth of all patients.1 For unexplained reasons, symptoms of autonomic dysfunction develop in only a few, and fortunately they are only rarely devastating.Quantitative bedside . . .