Sudomotor dysfunction in type 1 diabetes: A case report

Sudomotor dysfunction is a frequent and early sign of diabetic neuropathy. It is a disorder of the autonomic nervous system that involves small fibers and is usually underdiagnosed despite the impact it has on the patients' quality of life. Its study is recommended as a strategy for early detection as an indicator of dysautonomic dysfunction and management of later complications. Although it can be highly disabling, it often goes unnoticed, as it is considered less alarming than other dysautonomic symptoms. We present the case of a diabetic patient with sudomotor disfunction who underwent a comprehensive autonomic nervous system evaluation. Unlike most related studies, this case highlights a combination of compensatory hyperhidrosis and distal anhidrosis, underscoring the variability in clinical signs of sudomotor dysfunction. Additionally, it demonstrates the importance of autonomic testing in differential diagnosis and emphasizes the need for further research into its pathophysiological mechanisms and effective therapeutic strategies.