This episode explores diabetic autonomic neuropathy — the widespread nerve damage from chronic high blood sugar that affects the heart, gastrointestinal tract, bladder, sweat glands and more. It explains how this condition can cause silent heart attacks, resting tachycardia, orthostatic symptoms, gastroparesis, bladder and sexual dysfunction, and why diabetic foot ulcers may be a visible sign of deeper systemic disease.

We cover the main mechanisms (polyol pathway, AGEs, oxidative stress, microvascular ischemia), how clinicians diagnose it (heart rate variability, tilt-table, troponin, imaging), and practical prevention and management steps: tight glucose control, vascular care, blood pressure and cholesterol management, exercise, and multidisciplinary follow-up.