Books

Dizzy when you stand up? Full after a few bites? A racing heart at rest, changes in sweating, bladder or sexual problems, or low blood sugars you no longer feel coming?

If you live with diabetes, these symptoms may be signs of diabetic autonomic neuropathy (DAN), damage to the nerves that run your body's "autopilot": heart rate, blood pressure, digestion, bladder, sexual function, sweating, and the pupils of your eyes. DAN is common, often missed, and easy to confuse with other conditions. Some of those look-alikes, such as vitamin B12 deficiency linked to long-term metformin use or thyroid disease, can be very treatable once they are found.

This plain-language guide was written by Brian P Denman, a patient living with diabetic autonomic neuropathy, for patients and the families who support them. It is built on the American Diabetes Association Standards of Care in Diabetes 2026, the National Institutes of Health, and peer-reviewed medical reviews, with numbered references throughout so you and your care team can check every key point.

Inside you will learn:

• What neuropathy is, and how peripheral, autonomic, and focal neuropathy differ
• How DAN can affect each part of the body: cardiovascular autonomic neuropathy, orthostatic hypotension, gastroparesis, bladder problems, sexual health, sweating changes, hypoglycemia unawareness, and pupil changes
• The conditions that can mimic DAN or cause similar nerve problems, including B12 deficiency, thyroid disease, alcohol, medications, chemotherapy, amyloidosis, autoimmune autonomic ganglionopathy, POTS, Parkinson's disease and multiple system atrophy, Sjogren's disease, celiac disease, HIV, small fiber neuropathy, and CIDP, with the clues that can point toward each one
• How autonomic neuropathy is diagnosed, in everyday words: cardiovascular reflex tests, heart rate variability, tilt table testing, sweat testing, gastric emptying studies, skin biopsy, and the lab tests worth asking about
• Treatment and management options, from glucose, blood pressure, and lipid management to symptom-specific approaches, each labeled with a simple badge showing how strong the evidence is
• Red flags that need urgent medical care
• How to think about unproven and heavily marketed treatments, including stem cell clinics, without losing hope

Practical tools for your next appointment: questions to ask your doctor, a weekly symptom tracker, a lying-and-standing blood pressure log, a meals, digestion, and glucose log, a medicines and supplements list, and an appointment page, plus a glossary of medical terms.

Who this book is for: people with type 1 or type 2 diabetes who have symptoms they cannot explain, people who have been told they have diabetic neuropathy and want to understand it, and the spouses, partners, adult children, and caregivers who go to appointments with them. If you have ever left a doctor's office wishing you had known what to ask, this book is meant for you.

The tone is warm, honest, and practical. You will not find miracle cures or promises here. You will find clear explanations, a fair look at what the research does and does not show, and tools to help you work with your clinicians as a partner.

Full color, with original diagrams, summary boxes, and quick-reference tables.

This book is for education only and is not medical advice. It does not replace care from your own doctor or care team. The author is a patient, not a physician.

Brian P Denman is also the author of Comprehensive Guide to Stem Cells and Their Treatments.