Diabetic neuropathy Flashcards
What is diabetic neuropathy?
Diabetic neuropathy is a complication of diabetes that typically leads to sensory loss, often in a ‘glove and stocking’ distribution.
What is the typical progression of sensory loss in diabetic neuropathy?
Sensory loss typically starts in the lower legs due to the length of the sensory neurons supplying this area.
What is a common problem associated with diabetic neuropathy?
Painful diabetic neuropathy is a common issue in clinical practice.
What are the first-line treatments for diabetic neuropathy?
First-line treatments include amitriptyline, duloxetine, gabapentin, or pregabalin.
What should be done if the first-line drug treatment for diabetic neuropathy does not work?
If the first-line drug treatment does not work, try one of the other three drugs.
What is tramadol used for in the context of diabetic neuropathy?
Tramadol may be used as ‘rescue therapy’ for exacerbations of neuropathic pain.
What topical treatment may be used for localized neuropathic pain?
Topical capsaicin may be used for localized neuropathic pain, such as post-herpetic neuralgia.
What can be useful for patients with resistant neuropathic pain?
Pain management clinics may be useful for patients with resistant problems.
What is gastroparesis in relation to diabetic neuropathy?
Gastroparesis occurs secondary to autonomic neuropathy and can lead to erratic blood glucose control, bloating, and vomiting.
What are the management options for gastroparesis?
Management options include metoclopramide, domperidone, or erythromycin (prokinetic agents).
What is a common symptom of chronic diarrhoea related to diabetic neuropathy?
Chronic diarrhoea often occurs at night.
What causes gastro-oesophageal reflux disease in diabetic neuropathy?
Gastro-oesophageal reflux disease is caused by decreased lower esophageal sphincter (LES) pressure.
