Endocrinology Book

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Bilateral Peripheral Polyneuropathy in Diabetes

Aka: Bilateral Peripheral Polyneuropathy in Diabetes, Diabetic Distal Symmetric Polyneuropathy
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  1. Epidemiology
    1. Most common Diabetic Neuropathy
  2. Symptoms
    1. Distal Paresthesias, hyperesthesias or numbness
    2. Symptoms worse at night
    3. "Stocking & Glove" Neuropathy
      1. Related to longest axons affected first
    4. Muscle Weakness and atrophy may be noted
  3. Signs: Specific nerve functions affected
    1. Vibration and position sense
      1. Achilles and Patellar tendon Deep Tendon Reflexes
      2. Gait ataxia
    2. Sharp-dull discrimination
    3. Two Point Discrimination
    4. Decreased "protective sensation"
      1. 10 g Monofilament Test
    5. Muscle Strength may also be affected
  4. Differential Diagnosis
    1. Polyneuropathy

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