Orthostatic hypotension (drop in blood pressure after changing posture from supine to standing)
Dizziness and syncope
Diabetic autonomic neuropathy:
Gastrointestinal system
Diminished lower esophageal sphincter tone → Gastroesophageal reflux disease (GERD)
Diminished gastric emptying → gastroparesis with early satiety
Chronic diarrhea
Risk for aspiration even if no oral intake
Cardiovascular system
Loss of heart rate variability
Resting tachycardia
Poor exercise tolerance
Orthostatic hypotension
Cardiac ischemia (silent, unexpected)
Peripheral vasomotor tone
Anhidrosis (lack of sweating) in the hands and feet
Skin, nail, hair changes in distal extremities
Peripheral edema
Hypoglycemia unawareness (due to lack of symptoms)
Erectile dysfunction
Bladder dysfunction.
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