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Bilateral Peripheral Polyneuropathy in DiabetesAka: Diabetic Distal Symmetric Polyneuropathy

Epidemiology
1. Most common Diabetic Neuropathy
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
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
Differential Diagnosis
1. Polyneuropathy

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.