Can Autonomic Dysfunction be a sign of diabetic complications?

I was wondering if any of you have have issues with autonomic dysfunction? I have recently been diagnosed with hypertension, but it only happens when I’m standing/walking. My BP is otherwise completely normal when sitting down. I was just washing dishes earlier and my BP was 140/106. Sometimes it can be 160 over 120. I don’t freak out anymore as I’m used to it. I just sit down when my BP goes too high. I was treating this with Lisinopril, but it was lowering my BP too low when sitting. I stopped treating this and just ignore it for the most part unless I’m feeling unwell and then I might check my BP to make sure it’s not deadly high. I have read that this can be a sign of diabetic neuropathy in some diabetics. I wonder if this means my pre-diabetes/diabetes was out of control for a long time. Do any of you guys have this issue? I’m just wondering.

J

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The term for this type of autonomic dysfunction is Orthostatic Hypertension. I have read that a huge percentage of type 2 diabetics have this condition. It’s an abnormal androgenic response to standing up. I had my standing BP at 120/130 over 80 with 10 mgs of Lisinopril, but it was dropping down to 70/40 at times when sitting down. That really freaked me out and I discontinued medication. The week I started meds I had 2 doctor office readings of 170/110 and a few in home readings of 140/170 over 140/155. I haven’t had any high like that lately though. I also have a very high HR when standing. My HR can go to 130 BPM just from standing in the kitchen and grating cheese by hand. My HR usually goes up 30 points from the sitting to the standing position. I can sometimes feel the blood pumping and pounding in my neck. My doctor doesn’t really know what to make of this as he has never seen it before. He only agrees that I should not continue to take meds if my BP is dropping when sitting.

When my BP was deadly high, the 170/155 level, I immediately sat down, and within a few minutes my BP had dropped to 118/76. I don’t go to the ER for this as I can self-correct it by sitting down. I check my BP every day as well. Once when standing, and then again when sitting and I get the same results. It’s completely stable and predictable. I wish I had known this earlier, as I had a year long quest to find out why I feel so dizzy and out of breath when standing. I had some unnecessary CT scans and I was checked for chronic blood clots in my lungs and all was clear. I also had a few trips to the ER that missed this, as they only checked my vitals when I was sitting down. It wasn’t until my last doctor visit when they checked my BP within seconds of sitting down and caught the high readings before they dipped. I felt like I couldn’t breathe that day and very ill.

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I also have Orthostatic Hypotension, but I don’t think it’s diabetes or complications related. I had it as a kid when I exercised a ton. Since diagnosis, I’ve gotten back to training as an amateur (but serious) athlete, for triathlons as well as Olympic weightlifting. While my BP is very good (averages about 110/60), I have had serious positional hypotension (the common name for the condition) over the last year, but it is probably just noticeable now because I’m training a lot (which lowers BP).

Anyhow, the low blood pressure is called hypotension. Orthostatic “hypertension” would be if changing position raised your blood pressure.

Let us know how it goes!

I really don’t know what to do about it other than not exert myself. Orthostatic Hypertension and Hypotension also goes with my other disorder Hughes Syndrome, but I’m not so sure about that. It’s just a very weird medical issue. The one you have is POTS I think.

"Can Autonomic Dysfunction be a sign of diabetic complications?"

Positively, emphatically yes. I have a good friend who is now mostly confined to a wheelchair for just that reason.

That’s what scares me. I had a BP today of 148/112 just from washing dishes. But now that I’m sitting down again, my BP is 120/78. How do I treat the high BP if it only happens with standing? I got so frustrated with it I am mostly checking it once a day just to make sure it stays stable and I completely ignore it the rest of the time. It’s weird. I might have had this before the diabetes though as I had some really high BP readings as a kid. I have thick blood too that can cause high BP. But if it is from diabetes (which it may very well be) it means I already have some complications. I also get light burning cold sensations in my hands and feet. Been having those today. But again, my blood disorder has been known to cause neuropathy because it is hard for oxygen to get to the nerves when the blood is too thick to move around the system. What kind of autonomic dysfunction does your friend have? Is it high BP or low BP? Just wondering.

J

I should have given a bit more context; I realize I made that sound more cut and dried than it is. T1 is only one of my friend’s problems. He also has COPD from years of smoking and was seriously (I mean, seriously) overweight for quite some time, though he’s better now. He was also working 14 to 16 hours a day for more than a decade as the owner of a business. So diabetes isn’t his only issue, but the connection you asked about is quite real, though as with everything involving diabetes the variability from case to case is tremendous.

Wow, he’s working a lot of hours. I did that for almost two straight years when I ran my trucking company. I had the blood clots and that pretty much whipped me out for almost two more years and I had to sell my half of the company to my partner who eventually ran the thing into the ground. I was pulling 16 hour days during the week and 5 hours on Saturday and another five hours on Sunday. I had to do paperwork and payroll (pay the drivers) on the weekend, because that was the only time the phones weren’t ringing off the hook. Your friend has more than likely worked himself into complications. When I was driving for 7 years, I would regularly put in 100 hours a week. Sometimes I would drive for over 24 hours with maybe one 30 minute nap and a few fifteen minute fuel stops. I used to be a machine. But all machines break down from time to time.