[Autonomic symptoms in diabetic polyneuropathies]

Area of Science:

• Endocrinology
• Neurology
• Diabetology

Context:

• Diabetic polyneuropathy (PNP) has been recognized for 200 years.
• A close relationship exists between somatic and visceral symptoms in diabetic PNP.
• Autonomic nervous system dysfunction is a significant complication of diabetes mellitus.

Purpose:

• To classify autonomic disturbances in diabetic PNP from organotopic and phenomenologic aspects.
• To highlight the impact of autonomic denervation on various organ systems.
• To discuss emerging diagnostic methods for subclinical autonomic dysfunction.

Summary:

• Diabetic polyneuropathy (PNP) affects longer nerve fibers, including autonomic ones, leading to somatovisceral symptoms.
• Organotopic and phenomenologic classification of autonomic disturbances is proposed due to limited pathogenetic knowledge.
• Cardiovascular, gastrointestinal, and other organ dysfunctions are discussed, emphasizing vascular denervation as a key factor.

Impact:

• Early detection of autonomic dysfunction in diabetes is becoming possible with new examination methods.
• The reversibility of subclinical autonomic abnormalities with improved metabolic control requires further investigation.
• Understanding autonomic dysfunction in diabetic PNP is crucial for managing complications and improving patient outcomes.