Diabetic Neuropathy

Question 1

Describe peripheral neuropathy that diabetes typically leads to

Answer 1

Sensory NOT motor loss.

Question 2

Describe the sensory loss seen in diabetic neuropathy

Answer 2

‘Glove and stocking’ pattern, with lower legs affected first.

This can be painful.

Question 3

1st line mx of painful diabetic neuropathy?

Answer 3

Managed same way as other types of neuropathic pain:

• amitriptyline
• duloxetine
• gabapentin
• pregabalin

Question 4

Diabetes can cause peripheral & autonomic neuropathy.

What are some problems caused by autonomic neuropathy?

Answer 4

1) Gastroparesis
2) Chronic diarrhoea (often occurs at night)
3) GORD

Question 5

Symptoms of gastroparesis seen in diabetic autonomic neuropathy?

Answer 5

• erratic blood glucose control
• bloating
• vomiting

Question 6

Mx of gastroparesis seen in diabetic autonomic neuropathy?

Answer 6

Prokinetic agents:
- metoclopramide
- domperidone
- erythromycin

Question 7

Cause of GORD in diabetic autonomic neuropathy?

Answer 7

Decreased lower oesophageal sphincter pressure