Autonomic Neuropathy Far Worse Than ‘Pins & Needles’ in the Feet

Years ago, when I complained of frequent trips to the toilet at night and recurring bouts of diarrhea, my doctor told me about Diabetic Autonomic Neuropathy (DAN). While the thought was scary, I forgot about it after my gastro problems disappeared (better BS control?).

However, recently a fellow TuDiabetes member came up with a query on DAN, making me return to my archives for another dekko before I replied to her. To cut the long story short, I developed the material into a full blogpost which you can find here.

Diabetic autonomic neuropathy is a stealthy complication of diabetes, developing slowly over the years and quietly robbing diabetic patients of their ability to sense when they are becoming hypoglycemic or having a heart attack. It can affect any organ of the body, from the gastrointestinal system to the skin, and its appearance portends a marked increase in the mortality risk of diabetic patients.

Essentially, diabetic autonomic neuropathy impairs the ability to conduct activities of daily living and lowers quality of life. Autonomic neuropathy is also associated with an increased risk of sudden death. It also accounts for a large portion of the cost of care.

For around 50 percent diabetics, living with diabetic peripheral neuropathy ‒ that “pins and needles” feeling you get after your foot falls asleep, along with a burning sensation, and possibly numbness and loss of balance and no way to relieve it ‒ is a daily reality. When the peripheral nervous system fails, the patient becomes a vegetable.

Diabetic neuropathy is categorized as autonomic and peripheral diabetic neuropathy, depending on which particular nervous system it affects. The third category, focal diabetic neuropathy, affects individual nerves, not a system. (See my earlier related post ‘All Eyes on Research That May Provide Cure for Diabetic Neuropathy’ here.)

Diabetes can cause dysfunction of any or every part of the autonomic nervous system, leading to a wide range of disorders. And these are serious. Among the most troublesome and dangerous of the conditions linked to autonomic neuropathy are known: silent myocardial infarction (MI), cardiac arrhythmias (abnormal heart rhythm), ulceration (formation or development of an ulcer), gangrene, and nephropathy (damage to or disease of the kidney).

The prognosis is bleak: While treatment relieves pain and can control some symptoms, the disease generally continues to get worse.