(Neuro)

Overview

• Highly prevalent complication of T1 and T2 diabetes characterised by presence of signs of peripheral nerve dysfunction and/or autonomic nerve dysfunction
• Most common chronic complication of diabetes, caused by blockage of vasa nervorum
• Chronic hyperglycaemia → glycation of axon proteins → neuropathy
• Primary cause of diabetic foot problems and ulceration, the leading causes of diabetes-related hospital admissions and non-traumatic amputation.
• Risk Factors → poorly controlled hyperglycaemia, older age (>70yrs old), prolonged duration of diabetes (>10yrs), tall stature, hypertension, dyslipidaemia

Making Diagnosis

Clinical Features:

Up to 50% of patients with DN may be comlpetely asymptomatic.

Peripheral Neuropathy:

• Pain (Peripheral) → described as burning/sticking/aching. Often worse at night and may disturb sleep.

• Loss of Sensation (Peripheral) → at early stage affects tips of toes or fingers. Eventually causes a symmetrical distal sensory loss in a 'glove and stocking distribution’.

• Dysaesthesia (Peripheral) → burning sensation in feet

• Reduced/Absent Ankle Reflexes (Peripheral)

• Painless Injuries (Peripheral) → occur at pressure points. Infection is a common complication, followed by gangerene if vascular compromise.

  <aside> 💡 Diabetic Neuropathy ⇒ sensory loss and no motor loss

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