Diabetic neuropathy (DN) is a common and serious long-term complication of diabetes, with autonomic neuropathy gaining considerable attention due to its effects on various organ systems. The dysfunction of autonomic nerves is caused by pathological mechanisms such as metabolic imbalances, oxidative stress, and microvascular damage due to high blood sugar levels, leading to clinical symptoms like resting tachycardia, delayed stomach emptying, and bladder issues. The management of diabetic autonomic neuropathy (DAN) involves a foundational approach of stringent glycemic control, complemented by a combination of aldose reductase inhibitors, antioxidants, and neurotrophic agents to synergistically alleviate clinical symptoms. Furthermore, the utilization of neuromodulation techniques and the implementation of personalized treatments enable targeted modulation of the systemic impairments. This article provides a comprehensive review of the pathophysiological mechanisms of DAN, its clinical manifestations across multiple tissues and organs, and treatment strategies based on autonomic nervous system regulation, aiming to establish a theoretical foundation for in-depth analysis of DN pathological mechanisms and optimization of clinical intervention approaches.

糖尿病神经病变（DN）是糖尿病最常见且最具破坏性的慢性并发症，其中自主神经病变因累及多器官系统功能而备受关注。高血糖引发的代谢异常、氧化应激与微血管病变等病理机制可导致自主神经功能紊乱，引发静息心动过速、胃轻瘫、膀胱功能障碍等临床症状。在糖尿病自主神经病变（DAN）治疗方面，优化血糖控制为基础，同时结合醛糖还原酶抑制剂、抗氧化剂及神经营养药物协同缓解临床症状。此外通过利用神经调控技术以及实施个体化干预，可实现对系统性损伤的靶向调节。该文就DAN的病理生理机制、多组织器官的临床表现以及基于自主神经系统调控的治疗策略进行综述，旨在为深入解析DN病理机制及优化临床干预策略提供理论基础。