What is a manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus?

Autonomic neuropathy is a common complication of diabetes mellitus, particularly in older adults, and can significantly affect various body systems. One of the hallmark manifestations of autonomic neuropathy is orthostatic hypotension, which is characterized by a drop in blood pressure when a person transitions from lying down to sitting or standing. This occurs due to impaired autonomic regulation of blood pressure, as the autonomic nervous system is unable to compensate adequately, leading to dizziness, lightheadedness, or even fainting.

In a 70-year-old patient with diabetes, the presence of orthostatic hypotension indicates that the autonomic nervous system is not functioning optimally, which is a direct result of neuropathic changes caused by prolonged elevated blood glucose levels. In contrast, tremors and hypertension are not typically associated with autonomic neuropathy in this population; trembling generally indicates different neurological problems, while hypertension may be related to other factors such as lifestyle or medications rather than a failure of the autonomic nervous system. Thus, orthostatic hypotension stands out as the correct manifestation in this scenario.