skip to main content

Diabetic autonomic neuropathy — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardDiabetes complicationsDiabetic autonomic neuropathySCE Endocrinology

A 54-year-old man with diabetes has postural dizziness, erectile dysfunction and sweating after meals. Lying BP is 142/84 mmHg and standing BP after 3 minutes is 96/62 mmHg without compensatory tachycardia. What is the underlying pathophysiology?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Autonomic neuropathy causing impaired sympathetic vasoconstriction

Autonomic neuropathy causing impaired sympathetic vasoconstriction is best because orthostatic hypotension without an adequate tachycardic response indicates autonomic failure from impaired sympathetic vasoconstriction. The alternatives are less appropriate because aldosterone and catecholamine excess cause hypertension; diabetes insipidus causes polyuria; thyrotoxicosis does not explain the absent reflex tachycardia. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG28; autonomic neuropathy guidance