Diabetic Neuropathy

Question 1

What is a common complication of type 1 and type 2 diabetes?

Answer 1

Diabetic neuropathy

Characterised by progressive degeneration of peripheral nerves.

Question 2

What leads to the progressive neuronal injury in diabetic neuropathy?

Answer 2

Chronic hyperglycaemia → increased intracellular glucose in peripheral nerves

This is due to a complex interplay of factors.

Question 3

What are positive sensory symptoms of diabetic neuropathy?

Answer 3

• Paraesthesia
• Dysesthesia
• Pain worse at night

Positive phenomena refer to sensations that should not be present.

Question 4

What are negative sensory symptoms of diabetic neuropathy?

Answer 4

• Hypoesthesia
• Anaesthesia

Negative phenomena refer to loss of sensations that should be present.

Question 5

What motor symptoms are associated with diabetic neuropathy?

Answer 5

• Muscle weakness
• Atrophy
• Difficulty with ambulation and balance

These symptoms affect mobility and physical coordination.

Question 6

List some autonomic symptoms of diabetic neuropathy.

Answer 6

• Gastroparesis
• Erectile dysfunction
• Neurogenic bladder
• Orthostatic hypotension
• Sudomotor dysfunction (anhidrosis or hyperhidrosis)

Autonomic symptoms affect involuntary bodily functions.

Question 7

What investigations are used to diagnose diabetic neuropathy?

Answer 7

• Blood tests (HbA1c, vitamin B12)
• Urinalysis
• Nerve conduction studies
• Quantitative sensory testing

These tests assess nerve function and overall health.

Question 8

What is the primary management strategy for diabetic neuropathy?

Answer 8

Good glycaemic control

Maintaining blood sugar levels within target range is essential.

Question 9

Name two classes of medications used for pain management in diabetic neuropathy.

Answer 9

• Tricyclic antidepressants (e.g., amitriptyline)
• Gabapentinoids (e.g., gabapentin, pregabalin)

These medications help alleviate neuropathic pain.

Question 10

What lifestyle changes may be recommended for managing diabetic neuropathy?

Answer 10

Lifestyle changes

This may include diet, exercise, and smoking cessation.

Question 11

What are some complications associated with diabetic neuropathy?

Answer 11

• Peripheral vascular disease
• Foot ulcers
• Infections
• Limb amputation

These complications arise due to nerve damage and impaired circulation.