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Diabetic autonomic neuropathy — SCE Endocrinology MCQ

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ModerateDiabetesDiabetic autonomic neuropathySCE Endocrinology

A 52-year-old man with type 2 diabetes has painful erectile dysfunction and postural dizziness. Lying BP is 138/78 mmHg and standing BP after 3 minutes is 102/64 mmHg. HbA1c is 76 mmol/mol. What is the most likely diagnosis?

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Correct answer: D — Diabetic autonomic neuropathy

Erectile dysfunction with orthostatic hypotension in long-standing diabetes suggests autonomic neuropathy. Phaeochromocytoma usually causes paroxysmal hypertension rather than postural hypotension. Addison's can cause postural symptoms but would not explain the diabetic neuropathic cluster as well.

Reference: NICE NG28; NICE NG17