Diabetic neuropathy Flashcards
What can diabetes cause?
Sensory loss but not motor loss
How does sensory loss typically present in someone with diabetic neuropathy?
‘Glove and stocking’ distribution
(affects hands and feet symmetrically)
What is usually affected first in someone with diabetic neuropathy?
Lower legs affected first due to the length of the sensory neurons supplying this area
What is the first line management of diabetic neuropathy?
Amitriptyline
Duloxetine
Gabapentin
Pregabalin
What should be tried if amitriptyline is unsuccessful?
Duloxetine
Gabapentin
Pregabalin
What medication can be used as a resuce therapy for exaccerbations of neuropathy?
Tramadol
What medication can be used for localised neuropathic pain?
Topical capsaicin
Where can patients be referred in neuropathy is resistant to medication?
O
Pain management clinics
What can Gastrointestinal autonomic neuropathy include?
Gastroparesis
Chronic diarrhoea
Gastro-oesophageal reflux disease
Whata re the main symptoms of gastroparesis?
Erratic blood glucose control, bloating and vomiting
What is the main management of gastroparesis?
metoclopramide, domperidone or erythromycin
When does chronic diarrhoea tend to occur?
At night
What is GORD due to in this instance?
Decreased lower esophageal sphincter (LES) pressure
