Main Clinical Alterations to the Autonomic Nervous System Observed in Diabetes Mellitus

Abstract

Introduction: The damage to the peripheral nervous system, caused by high blood glucose levels in people with diabetes mellitus, can be revealed through alterations of the autonomic nervous system, which originates a particular clinical picture with different clinical manifestations that allow making the presumptive diagnosis of a diabetic autonomic neuropathy.

Objective: To describe the main clinical alterations of the autonomic nervous system observed in patients with diabetes mellitus.

Methods: A descriptive literature review was conducted. The search engines of the Google Scholar, SciELO and PubMed databases were used for this purpose. The used keywords were diabetes mellitus, complicaciones [complications]; neuropatía diabética [diabetic neuropathy] and neuropatía autonómica [autonomic neuropathy]. Review articles, research papers and web pages were included, generally less than five years old, in Spanish, Portuguese or English, and referring to the subject of the study within their titles. The most important and appropriate articles were chosen according to the author's criteria. This allowed 42 articles to be referenced.

Conclusions: The main clinical alterations of the autonomic nervous system observed in patients with diabetes mellitus are evidenced through the characteristic clinical picture of an autonomic neuropathy, which affects especially the cardiovascular, genitourinary and gastrointestinal systems, causing a significant affectation to the patient's health and quality of life. It can also disrupt ventilatory function, ocular structures and the periphery of the body, as well as contribute to the occurrence of hypoglycemia episodes without warning.