Diabetes Complications: Neuropathy Flashcards
what types of neuropathy are seen in diabetes
peripheral, proximal(rare), autonomic, focal neuropathy
what is the most common type of neuropathy seen in diabetes
peripheral
describe peripheral neuropathy
pain/loss of feeling in feet and hands
‘glove and stocking neuropathy’
describe proximal neuropathy
pain in thighs, hip, buttocks leading to weakness in legs
usually one sided and self-limiting
describe autonomic neuropathy
affect autonomic nerve system; changes in bowel, bladder function, sexual response, sweating, heart rate, blood pressure
describe focal neuropathy
sudden weakness in one nerve or a group of nerves causing muscle weakness or pain
(eg carpal tunnel)
what are some of the risk factors for neuropathy
increased length of diabetes, poor glycaemic controls, T1DM>T2DM, high cholesterol/lipids, smoking, alcohol, genes
what are the symptoms associated with peripheral neuropathy
numbness/insensitivity, tingling/burning, sharp pain/cramps, sensitivity to touch, loss of balance/coordination
what are some of the consequences of peripheral neuropathy
painless trauma, foot ulcer, Charcot foot, peripheral vascular disease
what are the features of the ‘diabetic foot’
neuropathic ulcer, proximal arterial occlusion, digital gangrene, Charcot’s foot, clawing of toes
what is Charcot arthropathy
destructive inflammatory process, fractures/bony destruction and deformity of the foot
(lasts around 3 months, 8 months recovery)
what is the presentation of Charcot arthropathy
present as hot swollen foot in someone with neuropathy
what treatment is used for Charcot
non-weight bearing; total contact cast or air boost
what features are seen as being at high risk of diabetic foot complications
sensation impaired + foot pulses absent and/or if skin callus or foot deformity
what are some of the drugs that can be used to treat painful neuropathy
amitriptyline, gabapentin
don’t always work very well and can cause more issues with side effects
