Aims: To determine whether there is an association between high blood glucose levels and having autonomic symptoms among adults aged 30–69 years. Material and methods: A population-based cross-sectional study was conducted. The presence of autonomic symptoms was defined as the positive response to any item of the Survey of Autonomic Symptoms (SAS). Blood glucose levels were defined as euglycemia, prediabetes, and type 2 diabetes (T2D), based on oral glucose tolerance test. Poisson regression, with link log and robust variance, and linear regression were conducted to evaluate the association of interest. Results: A total of 1607 subjects, mean age 48.2 (SD: 10.6) and 810 (49.7 %) women, were included. T2D was associated with higher prevalence of erectile dysfunction (PR = 3.00; 95 % CI: 1.78–5.02) and dryness of mouth and eyes (PR = 1.29; 95 % CI: 1.02–1.61) compared with those with euglycemia. Those with T2D had 0.32 (95 % CI: 0.04–0.62) and 1.03 (95 % CI: 0.03–2.03) more points in the SAS score and severity scale, respectively. Conclusions: Erectile dysfunction and dry mouth and eyes are the more common autonomic symptoms associated with T2D. Our results suggest a periodic evaluation of sexual function and eye humidity among T2D patients.