Less than a quarter of people with diabetes have diabetic neuropathy, the result of nerve damage caused by high triglycerides or blood sugar. While the cause is the same, in autonomic neuropathy the damage affects the nerves that control internal organs, leading to problems with eyes, heart rate, blood pressure, and the inability to sense low blood sugar or hypotension unawareness. Gastroparesis, where the movement of food from the stomach to the small intestine slows or stops, is another potential symptom of diabetic autonomic neuropathy. The body's inability to absorb glucose and use insulin makes it difficult to manage blood sugar.

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