Niakan E, Harati Y, Comstock J P
Metabolism. 1986 Mar;35(3):224-34. doi: 10.1016/0026-0495(86)90205-2.
The incidence of autonomic dysfunction as a complication of diabetes mellitus is reported to be as high as 20% to 40%. Symptoms of diabetic autonomic neuropathy (DAN) are often vague, and signs difficult to detect on routine physical examination. The early diagnosis of DAN is possible by utilizing several simple noninvasive tests, which may also be helpful in localizing the lesion(s) to specific autonomic pathways. DAN may affect multiple organ systems, to include cardiovascular, gastrointestinal, genitourinary and/or neuroendocrine, and may, in fact, be life-threatening. The same metabolic disturbances of somatic peripheral nerve may also be responsible for DAN. Like somatosensory neuropathy, definitive therapy for DAN is not yet satisfactory, although multiple chemotherapeutic agents have been tried and warrant further investigation.
据报道，自主神经功能障碍作为糖尿病并发症的发生率高达20%至40%。糖尿病自主神经病变（DAN）的症状通常不明确，体征在常规体格检查中难以发现。通过使用几种简单的非侵入性检查可以早期诊断DAN，这些检查也有助于将病变定位到特定的自主神经通路。DAN可能影响多个器官系统，包括心血管、胃肠道、泌尿生殖和/或神经内分泌系统，实际上可能危及生命。躯体周围神经的相同代谢紊乱也可能是DAN的原因。与躯体感觉神经病变一样，尽管已经尝试了多种化疗药物并值得进一步研究，但DAN的确定性治疗仍不尽人意。
