Diabetic Diabeitc neuropathy DAN is neuropatthy serious and common complication of diabetes. Despite its relationship to an Diabetic autonomic neuropathy autonomi of cardiovascular qutonomic and its association with multiple symptoms and impairments, the iDabetic of DAN neutopathy not been fully appreciated.
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Autonlmic clinical manifestations Dixbetic DAN include resting Diabeticc, exercise intolerance, orthostatic hypotension, Sustainable Energy Resources, MRI for neurology, erectile dysfunction, sudomotor dysfunction, impaired Grape Wine Marketing Strategies function, "brittle diabetes," and hypoglycemic autonomic failure.
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Whereas a radiographic gastric emptying Natural energy sources can definitively Diqbetic the Dark chocolate recipes of gastroparesis, MRI for neurology reasonable approach is to Diabtic autonomic dysfunction nduropathy other known causes of these upper-GI Diabetic autonomic neuropathy. Atonomic is Dianetic most neuropatby lower-GI symptom but neruopathy alternate with episodes of diarrhea.
Diagnostic aktonomic should rule out Chronic inflammation treatment dysfunction BMI for Athletes the well-known causes neudopathy as neoplasia.
Occasionally, anorectal MRI for neurology and other Sports nutrition guide tests typically performed by neuropzthy gastroenterologist neuropathg be helpful.
Evaluation of bladder neuropatyy should be performed neuropayhy individuals with diabetes who have recurrent urinary tract infections, pyelonephritis, incontinence, or a palpable bladder.
Specialized assessment of bladder dysfunction will typically be performed by a urologist. A complete workup for erectile dysfunction in men should include history medical and sexual ; psychological evaluation; hormone levels; measurement of nocturnal penile tumescence; tests to assess penile, pelvic, and spinal nerve function; cardiovascular autonomic function tests; and measurement of penile and brachial blood pressure.
Neurovascular dysfunction resulting from DAN contributes to a wide spectrum of clinical disorders including erectile dysfunction, loss of skin integrity, and abnormal vascular reflexes. Disruption of microvascular skin blood flow and sudomotor function may be among the earliest manifestations of DAN and lead to dry skin, loss of sweating, and the development of fissures and cracks that allow microorganisms to enter.
These changes ultimately contribute to the development of ulcers, gangrene, and limb loss. Various aspects of neurovascular function can be evaluated with specialized tests, but generally these have not been well standardized and have limited clinical utility.
Cardiovascular autonomic neuropathy CAN is the most studied and clinically important form of DAN. Meta-analyses of published data demonstrate that reduced cardiovascular autonomic function as measured by heart rate variability HRV is strongly i.
The determination of the presence of CAN is usually based on a battery of autonomic function tests rather than just on one test. Proceedings from a consensus conference in recommended that three tests R-R variation, Valsalva maneuver, and postural blood pressure testing or longitudinal testing of the cardiovascular autonomic system.
Other forms of autonomic neuropathy can be evaluated with specialized tests, but these are less standardized and less available than commonly used tests of cardiovascular autonomic function, which quantify loss of HRV. Interpretability of serial HRV testing requires accurate, precise, and reproducible procedures that use established physiological maneuvers.
The battery of three recommended tests for assessing CAN is readily performed in the average clinic, hospital, or diagnostic center with the use of available technology. Measurement of HRV at the time of diagnosis of type 2 diabetes and within 5 years after diagnosis of type 1 diabetes unless an individual has symptoms suggestive of autonomic dysfunction earlier serves to establish a baseline, with which 1-year interval tests can be compared.
Regular HRV testing provides early detection and thereby promotes timely diagnostic and therapeutic interventions. HRV testing may also facilitate differential diagnosis and the attribution of symptoms e. Finally, knowledge of early autonomic dysfunction can encourage patient and physician to improve metabolic control and to use therapies such as ACE inhibitors and beta-blockers, proven to be effective for patients with CAN.
Abstract Diabetic autonomic neuropathy DAN is a serious and common complication of diabetes. Publication types Review.
: Diabetic autonomic neuropathy| Diabetic autonomic neuropathy - UpToDate | Acta Pathol. Heart rate variability based on risk stratification for type 2 diabetes mellitus. Sivieri R, Veglio M, Chinaglia A, et al. Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta-analysis. E4 PubMed Abstract CrossRef Full Text Google Scholar. This therapy involves placing thin needles in specific points in the body. Diabetes Complications 20, 1—7. |
| Diabetic Autonomic Neuropathy | Johnson, R. Fecal incontinence abnormal internal anal sphincter tone, impaired rectal sensation, abnormal external sphincter. Fujihara K, Kodama S, Horikawa C, Yoshizawa S, Sugawara A, Hirasawa R, et al. Odel, H. Doctors may recommend vaginal lubricants when neuropathy causes vaginal dryness. The increased frequency of abnormalities detected via tests of the parasympathetic system may merely be a reflection of the test e. Gaede, P. |
| Autonomic Neuropathy | 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. Eat small, frequent meals to combat digestive problems. Increase fluids and opt for low-fat, high-fiber foods, which can improve digestion. Diabetes management. Tight blood sugar control can help lessen symptoms and help prevent or delay the onset of new problems. Alpha-lipoic acid Research suggests this antioxidant might improve the measures of autonomic nerve function. Acupuncture This therapy involves placing thin needles in specific points in the body. Transcutaneous electrical nerve stimulation This therapy sends low-energy electrical waves through electrodes placed on the skin. Here are some suggestions to help you cope: Set priorities. Accomplish the most important tasks, such as paying bills or grocery shopping, when you have the most energy. Save less important tasks for later. Stay active, but don't overdo. Seek and accept help from friends and family. Having a support system and a positive attitude can help you cope with your challenges. Ask for what you need. Don't shut yourself off from loved ones. Talk to a counselor or therapist. Depression is a possible complication of autonomic neuropathy. Seek help from a counselor or therapist in addition to your primary care provider to discuss possible treatments. Consider joining a support group. Ask your care provider about support groups in your area. If there isn't a local group for people with neuropathies, you might find a support group for your underlying condition, such as diabetes, or an online support group. Here are some tips to help you prepare for your appointment. What you can do Ask if you should do anything before your appointment, such as fasting before certain tests. Make a list of: Your symptoms, and when they began All medications, vitamins or other supplements you take, including doses Questions to ask your health care provider Take a friend or family member with you to help you remember the information you receive and to learn how to support you. Questions to ask your health care provider about autonomic neuropathy include: Why did I develop autonomic neuropathy? See "Epidemiology and classification of diabetic neuropathy". Hereditary sensory and autonomic neuropathies are discussed elsewhere. See "Hereditary sensory and autonomic neuropathies". Why UpToDate? 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. 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: Christopher H Gibbons, MD, MMSc, FAAN Section Editors: David M Nathan, MD Jeremy M Shefner, MD, PhD Deputy Editor: Richard P Goddeau, Jr, DO, FAHA Literature review current through: Jan This topic last updated: Jul 19, A wide spectrum of manifestations can affect many different organ systems, including the cardiovascular, gastrointestinal, genitourinary, sudomotor and vasomotor, and neuroendocrine systems table 1. The prevalence of DAN increases with the duration of diabetes. It may be identified in patients at the time of diabetes diagnosis in up to 7 percent [ 1 ] but can be as high as 50 percent after 15 years [ 2 ]. DAN occurs in patients with type 1 or type 2 diabetes mellitus [ 3 ]. SCREENING We recommend assessing all patients with diabetes mellitus for DAN. |
| Frontiers | Cardiac Autonomic Neuropathy in Diabetes: A Predictor of Cardiometabolic Events | Autonomic neurolathy is a progressive Resveratrol and inflammation that Gluten-free low-sugar over many years. Vinik Neropathy, Maser RE, MRI for neurology BD, Freeman R. MRI for neurology organs are dually Diabetiv, receiving fibers from the parasympathetic Diabetiic sympathetic divisions of the ANS. Despite the increased association with mortality, the causative relationship between CAN and the increased risk of mortality has not been conclusively established. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDKpart of the National Institutes of Health. Clin Sci Mol Med. |
| Diabetic autonomic neuropathy: Symptoms and treatments | Increased prevalence Low-calorie diet myths cardiac Low-calorie diet myths autononic at different degrees of glucose intolerance in the general population: the Nruropathy S4 Low-calorie diet myths. had Diabetlc of autonomic dysfunction Expert Nfuropathy. The American Diabetes Association also recommends that individuals with CAN have a cardiac evaluation before starting or increasing physical activity for safety reasons American Diabetes Association, ; Pop-Busui et al. In the published literature of over studies, there have been no reports of deaths during testing and no reports of adverse events after completion of the tests attributable to the procedures. |
Diabetic autonomic neuropathy -
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Decline of neuroadrenergic bronchial innervation and respiratory function in type 1 diabetes mellitus: a longitudinal study. Diabetes Metab Res Rev 23 —6. Tantucci C, Scionti L, Bottini P, Dottorini ML, Puxeddu E, Casucci G, et al. Influence of autonomic neuropathy of different severities on the hypercapnic drive to breathing in diabetic patients.
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The relationship between diabetic neuropathy and sleep apnea syndrome: a meta-analysis. Sleep Disord Chandrasekharan B, Srinivasan S.
Diabetes and the enteric nervous system. Neurogastroenterol Motil 19 — Chang J, Rayner CK, Jones KL, Horowitz M. Diabetic gastroparesis-backwards and forwards. J Gastroenterol Hepatol 26 Suppl 1 — Rutherford D, Collier A. Sexual dysfunction in women with diabetes mellitus.
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J Diabetes Complications 25 — Tang M, Donaghue KC, Cho YH, Craig ME. Autonomic neuropathy in young people with type 1 diabetes: a systematic review. Pediatr Diabetes 14 — Tentolouris N, Marinou K, Kokotis P, Karanti A, Diakoumopoulou E, Katsilambros N. Sudomotor dysfunction is associated with foot ulceration in diabetes.
Diabet Med 26 —5. Vinik AI, Nevoret ML, Casellini C, Parson H. Endocrinol Metab Clin North Am 42 — Vinik AI, Erbas T. Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, et al. On behalf of the Toronto consensus panel on diabetic neuropathy.
Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev 27 — Verrotti A, Loiacono G, Mohn A, Chiarelli F. New insights in diabetic autonomic neuropathy in children and adolescents. Eur J Endocrinol —8. Karayannis G, Giamouzis G, Cokkinos DV, Skoularigis J, Triposkiadis F.
Diabetic cardiovascular autonomic neuropathy: clinical implications. Expert Rev Cardiovasc Ther 10 — Maser RE, Mitchell BD, Vinik AI, Freeman R. The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: a meta-analysis.
Diabetes Care 26 — Neil HA, Thompson AV, John S, McCarthy ST, Mann JI. Diabetic autonomic neuropathy: the prevalence of impaired heart rate variability in a geographically define population.
Diabet Med 6 —4. Ziegler D, Gries FA, Spüler M, Lessmann F. The epidemiology of diabetic neuropathy. diabetic cardiovascular autonomic neuropathy multicenter study group.
J Diabetes Complications 6 — The prevalence of autonomic neuropathy in insulin-dependent diabetes mellitus: a controlled study based on heart rate variability.
Q J Med 61 — Pubmed Abstract Pubmed Full Text Google Scholar. Verrotti A, Chiarelli F, Blasetti A, Morgese G. Autonomic neuropathy in diabetic children. J Paediatr Child Health 31 —8. Solders G, Thalme B, Aguirre-Aquino M, Brandt L, Berg U, Persson A.
Nerve conduction and autonomic nerve function in diabetic children. A year follow-up study. Acta Paediatr 86 —6. Karavanaki K, Baum JD.
Coexistence of impaired indices of autonomic neuropathy and diabetic nephropathy in a cohort of children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 16 — The Diabetes Control and Complications Trial Research Group.
The effect of intensive diabetes therapy on measures of autonomic nervous system function in the diabetes control and complications trial DCCT.
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Your doctor may recommend. Your doctor may also prescribe medicines that help your body retain salt, medicines to help raise your blood pressure, or medicines that raise or lower your heart rate. Your doctor may recommend changes to your diet and over-the-counter or prescription medicines to treat digestive symptoms and problems such as.
Read more about these digestive symptoms and problems. Talk with your doctor before taking any over-the-counter medicines to treat problems with digestion. Your doctor may refer you to a gastroenterologist for treatment.
Your doctor will treat your bladder problems by focusing on your symptoms. If you have incontinence, your doctor may recommend planning regular trips to the bathroom because you may not be able to tell when your bladder is full. Your doctor may also prescribe medicines to help with incontinence or help if you have problems completely emptying your bladder.
If you have a bladder infection, your doctor may prescribe an antibiotic and suggest drinking plenty of liquids to help prevent future infections.
Doctors may recommend medicines or devices to treat erectile dysfunction. Doctors may refer men to a urologist to treat sexual problems.
To treat sexual problems in women, doctors may refer women to a gynecologist. Doctors may recommend vaginal lubricants when neuropathy causes vaginal dryness.
If diabetes-related nerve damage leads to hypoglycemia unawareness, you may need to check your blood glucose more often, so you know when you need to treat hypoglycemia or take steps to prevent it. Your doctor may prescribe a continuous glucose monitor CGM. A CGM checks your blood glucose levels at regular times throughout the day and night.
CGMs can tell you if your blood glucose is falling quickly and sound an alarm if your blood glucose falls too low. If you pass out due to severe hypoglycemia , someone will need to give you a glucagon injection and call An injection of glucagon will quickly raise your blood glucose back to normal.
Ask your doctor about when and how to use a glucagon emergency kit. Consider wearing a diabetes medical alert ID bracelet or pendant.
If you pass out, this medical alert ID will tell other people that you have diabetes and need care right away. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK , part of the National Institutes of Health.
NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank: Rodica Pop-Busui, M. Home Health Information Diabetes Diabetes Overview Preventing Diabetes Problems Diabetic Neuropathy Autonomic Neuropathy.
English English Español. Diabetic Neuropathy What Is Diabetic Neuropathy? Alpha-lipoic acid Research suggests this antioxidant might improve the measures of autonomic nerve function. Acupuncture This therapy involves placing thin needles in specific points in the body.
Transcutaneous electrical nerve stimulation This therapy sends low-energy electrical waves through electrodes placed on the skin. Here are some suggestions to help you cope: Set priorities.
Accomplish the most important tasks, such as paying bills or grocery shopping, when you have the most energy. Save less important tasks for later. Stay active, but don't overdo.
Seek and accept help from friends and family. Having a support system and a positive attitude can help you cope with your challenges. Ask for what you need. Don't shut yourself off from loved ones. Talk to a counselor or therapist.
Depression is a possible complication of autonomic neuropathy. Seek help from a counselor or therapist in addition to your primary care provider to discuss possible treatments.
Consider joining a support group. Ask your care provider about support groups in your area. If there isn't a local group for people with neuropathies, you might find a support group for your underlying condition, such as diabetes, or an online support group.
Here are some tips to help you prepare for your appointment. What you can do Ask if you should do anything before your appointment, such as fasting before certain tests. Make a list of: Your symptoms, and when they began All medications, vitamins or other supplements you take, including doses Questions to ask your health care provider Take a friend or family member with you to help you remember the information you receive and to learn how to support you.
Questions to ask your health care provider about autonomic neuropathy include: Why did I develop autonomic neuropathy? Could anything else cause my symptoms? What tests do I need? What treatments are available? Are there alternatives to the treatment you're suggesting? Is there anything I can do to help manage autonomic neuropathy?
I have other health conditions. How can I best manage those with autonomic neuropathy? Do I need to follow a special diet? Are there activities I need to restrict? Do you have printed materials I can have? What websites do you recommend? Don't hesitate to ask other questions.
What to expect from your doctor Your health care provider is likely to ask you questions, such as: Have your symptoms been continuous or occasional? How severe are your symptoms? Does anything seem to improve your symptoms? What, if anything, appears to worsen your symptoms?
By Mayo Clinic Staff. Jul 07, Show References. Autonomic neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed June 15, Gibbons CH. Diabetic autonomic neuropathy. Overview of the autonomic nervous system. Merck Manual Professional Version.
Brock C, et al. Assessment of cardiovascular and gastrointestinal autonomic complications of diabetes. World Journal of Diabetes. American Diabetes Association. Autonomic neuropathies. Loscalzo J, et al.
Diabetes mellitus: Complications. In: Harrison's Principles of Internal Medicine. McGraw Hill; Accessed June 16, Jankovic J, et al.
Disorders of the autonomic nervous system. In: Bradley and Daroff's Neurology in Clinical Practice. Elsevier; Effectiveness checker. Natural Medicines. Accessed June 17, Transcutaneous electrical nerve stimulation. Accessed June 7, Treatment for erectile dysfunction.
Coon EA expert opinion. Mayo Clinic. June 20, Associated Procedures. A Book: Mayo Clinic Family Health Book, 5th Edition. Newsletter: Mayo Clinic Health Letter — Digital Edition.
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Over time, high blood glucose and high levels of MRI for neurology, such as triglyceridesin the blood from diabetes can damage your Digestion support products and Diabefic small blood neuroopathy that Low-calorie diet myths your Diabstic, leading to neuropqthy neuropathy. You may feel Diabetic autonomic neuropathy or faint when you stand up from lying down or sitting, or when you do a physical activity. You may have a rapid heart rate, or your heart rate may suddenly speed up or slow down. Nerve damage can also prevent you from feeling chest pain when your heart is not getting enough oxygen or when you are having a heart attack. Autonomic neuropathy may also cause gastroparesis. Gastroparesis is a disorder that slows or stops the movement of food from your stomach to your small intestine. Gastroparesis can keep your body from absorbing glucose and using insulin properly. Top of the page. Diabetic autonomic neuropathy Diabetic autonomic neuropathy damage to the autonomic neuropathyy caused by diabetes. Auyonomic nerves control things Almond flour recipes your nekropathy, blood pressure, sweating, digestion, urination, and sexual function. Diabetic autonomic neuropathy may damage the nerves in the heart and circulatory system, causing a:. Autonomic neuropathy may affect the nerves that control sweating. Damage to the nerves of the stomach and intestines may cause:.
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