What is autonomic neuropathy?

Hypoglycemia Unawareness
Normally,symptoms such as shakiness,sweating,and palpitations occur when blood glucose levels drop below 70 mg/dL.In people with autonomic neuropathy,symptoms may not occur,making hypoglycemia difficult to recognize.Problems other than neuropathy can also cause hypoglycemia unawareness.For more information about hypoglycemia,see the fact sheet.
Heart and Blood Vessels
The heart and blood vessels are part of the cardiobascular system,which controls blood circulation.Damage to nerves in the cardiovascular system interferes with the body's ability to adjust blood pressure and heart rate.As a result,blood pressure may drop sharply after sitting or standing,causing a person to feel light-headed or even to faint.Damage to the nerves that control heart rate can mean that your heart rate stays high,instead of rising and falling in response to normal body functions and physical activity.
Digestive System
Nerve damage to the digestive system most commonly causes constipation.Damage can also cause the stomach to empty too slowly, a condition called gastroparesis.Severe gastroparesis can lesd to persistent nausea and vomiting, bloating,and loss of appetite.Gastroparesis can also make blood glucose levels fluctuate widely,due to abnormal food digestion.
Nerve damage to the esophagus may make swallowing difficult,while nerve damage to the bowels can cause constipation alternating with frequent,uncontrolled diarrhea,especially at night.Proplems with the digestive system can lead to weight loss.
Urinary Tract and Sex Organs
Autonomic neuropathy often affects the organs that control urination and sexual function.Nerve damage can prevent the bladder from emptying completely,allowing bacteria to grow in the bladder and kidneys and causing urinary tract infections.When the nerves of the bladder are damaged,urinary incontinence may result because a person may not be able to sense when the bladder if full or control the muscles that release urine.
Autonomic neutopathy can also gradually decrease sexual response in men and women,although the sex drive may be unchanged.A man may be unable to have erections or may reach sexual climax without ejaculating normally.A woman may have difficulay with arousal,lubrication,or orgasm.
Sweat Glands
Autonamic neuropathy can affect the nerves that control sweating.When nerve damage prevents the sweat glands from working properly, the body cannot regulate its temperature as it should.Nerve damage can also cause profuse sweating at night or while eating.
Eyes
Finally,autonomic neuropathy can affect the pupils of the eyes,making them less responsive to changes in light. As a result, a person may not be able to see well when a light is turned on in a dark room or may have trouble driving ar night.