First, you'll probably see your primary care physician. If you have diabetes, you may see your diabetes specialist (endocrinologist). However, you may be referred to a specialist in nerve disorders (neurologist).
You may need to see other specialists depending on the part of your body affected by neuropathy: for example, a cardiologist for problems with your blood pressure or heart rate, or a gastroenterologist for digestive difficulties.
Arrive at your appointment well-prepared. Here are some tips to help you prepare yourself and know what to expect from your doctor.
What you can do
- Ask about any restrictions before the appointment. Find out if you should do anything in advance, such as fasting before certain tests.
- Write down any symptoms you're experiencing, even those that may seem unrelated to autonomic neuropathy.
- Make a list of all medications (including over-the-counter), vitamins or supplements that you take.
- Ask a family member or friend to come with you. Bring someone who can help you remember the information you and your doctor discuss. Family members can learn more about autonomic neuropathy if they attend appointments with you. For example, if you don't know when your blood pressure is too low, you may pass out (faint). Your family members will need to know what to do.
- Write down questions to ask your doctor.
Since appointments can be short, prepare a list of questions before you go. Some basic questions to ask your doctor about autonomic neuropathy may include:
- Why did I develop autonomic neuropathy?
- Could anything else cause my symptoms?
- What kinds of tests do I need? Will I need to do anything to prepare?
- Is autonomic neuropathy temporary or chronic?
- What are the available and recommended treatments for autonomic neuropathy?
- What are the treatment side effects?
- Are there any alternatives to the treatment that you're suggesting?
- Is there anything I can do on my own to help manage autonomic neuropathy?
- I have other health conditions. How can I best manage those with autonomic neuropathy?
- Do I need to follow a special diet?
- Are there any activity restrictions that I need to follow?
- Do you have any printed materials or recommended websites that you can share with me?
Don't hesitate to ask additional questions that may come up during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Be prepared to answer these types of questions to allow more time for your own:
June 06, 2015
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Gardner DG, et al. Pancreatic Hormones and Diabetes Mellitus. In: Greenspan's Basic & Clinical Endocrinology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://accessmedicine.com. Accessed May 4, 2015.
- Callaghan BC, et al. Diabetic neuropathy: Clinical manifestations and current treatments. The Lancet Neurology. 2012;11:521. Accessed May 12, 2015.
- Stevens MJ. Diabetic autonomic neuropathy. http://www.uptodate.com/home. Accessed April 30, 2015.
- Tesfaye S, et al. Diabetic neuropathies: Update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33:2285. Accessed May 13, 2015.
- Longo DL, et al., eds. Disorders of the Autonomic Nervous System. In: Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed May 4, 2015.
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/. Accessed May 4, 2015.
- Overview of the autonomic nervous system. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic-disorders/autonomic-nervous-system/overview-of-the-autonomic-nervous-system. Accessed May 4, 2015.
- Philips JC, et al. Squatting, a posture test for studying cardiovascular autonomic neuropathy in diabetes. Diabetes & Metabolism. 2011;37:489.
- Bethanechol (prescribing information). Pomona, N.Y.: Barr Laboratories, Inc.; 2007. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=80ee6156-18b8-45aa-9402-b40647173da8. Accessed May 4, 2015.
- Detrol (prescribing information). New York, N.Y.: Pharmacia and Upjohn; 2012. http://labeling.pfizer.com/ShowLabeling.aspx?id=719. Accessed May 4, 2015.
- Ditropan (prescribing information). Raritan, N.J.: Ortho McNeil Pharmaceuticals; 2011. http://www.janssenpharmaceuticalsinc.com/assets/ditropanxl.pdf. Accessed May 4, 2015.
- Hirsch M, et al. Tricyclic and tetracyclic drugs: Pharmacology, administration, and side effects. http://www.uptodate.com/home. Accessed May 13, 2015.
- Robinul and Robinul Forte (prescribing information). Atlanta, Ga.: Shionogi Pharma, Inc.; 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/017558s053lbl.pdf. Accessed May 4, 2015.
- Shakher J, et al. Update on the management of diabetic polyneuropathies. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2011;4:289.
- Wang CP, et al. A single-blinded, randomized pilot study evaluating effects of electroacupuncture in diabetic patients with symptoms suggestive of gastroparesis. The Journal of Alternative and Complementary Medicine. 2008;7:833.
- Feldman, EL, et al. Treatment of diabetic neuropathy. http://uptodate.com/home. Accessed April 30, 2015.
- Rutkove SB. Overview of polyneuropathy. http://uptodate.com/home. Accessed April 30, 2015.
- Olshansky B. Upright tilt table testing in the evaluation of syncope. http://uptodate.com/home. Accessed April 30, 2015.
- Tesfaye S. Neuropathy in diabetes. Medicine. 2015;43:26. Accessed May 13, 2015.
- Coon E (expert opinion). Mayo Clinic, Rochester, Minn. May 14, 2015.