Endocrinology Book

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Bilateral Peripheral Polyneuropathy in Diabetes

Aka: Bilateral Peripheral Polyneuropathy in Diabetes, Diabetic Distal Symmetric Polyneuropathy, Diabetic Distal Sensorimotor Polyneuropathy
  1. Epidemiology
    1. Most common Diabetic Neuropathy
    2. Accounts for 26% of diabetic Peripheral 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
    5. Painful Peripheral Neuropathy occurs in a subset of diabetic Peripheral Neuropathy (20%)
      1. Pain due to light stroking (dynamic mechanical Allodynia)
      2. Increased Temperature sensitivity (thermal hyperalgesia)
      3. Pain attacks
  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
  5. Management
    1. See Diabetic Peripheral Neuropathy
  6. References
    1. Snyder (2016) Am Fam Physician 94(3): 227-34 [PubMed]

Diabetic distal sensorimotor polyneuropathy (C0393832)

Concepts Disease or Syndrome (T047)
SnomedCT 230573007
English Diabet dist snsorimotr polyneu, Diabetic distal sensorimotor polyneuropathy, Diabetic distal sensorimotor polyneuropathy (disorder)
Spanish polineuropatía sensorimotriz distal diabética (trastorno), polineuropatía sensorimotriz distal diabética
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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