Diabetic Neuropathy Flashcards
what is diabetic neuropathy
highly prevalent complication of diabetes (type 1 or type 2) and is characterised by the presence of symptoms and/or signs of peripheral nerve dysfunction and/or autonomic nerve dysfunction
when is DN diagnosed
after all other causes are ruled out. some people with DN are often asymptomatic.
often clinical diagnosis if peripheral signs are absent (e.g. loss of sensation, reduced reflexes, pain, tingling etc)
what causes diabetic neuropathy
hypertension and hyperlipidaemia damages the endothelium of the vasa nervorum
Small vessels like vasa vasorum and vasa nervorum are particularly susceptible to external mechanical compression. A decrease in blood flow through the vasa nervorum has been implicated in the development of diabetic neuropathy.
risk factors for developing diabetic neuropathy
hyperglycaemia, old age, hypertension, tall people, dyslipidaemia and hypertriglyceridaemia, obesity and smoking
how does diabetic neuropathy present
can be asymptomatic.
peripheral; pain, loss of sensation, dysaesthesia (pins and needles), reduced/ absent reflexes, painless injuries
autonomic; tachycardia, urinary osmotic symptoms (nocturia, polydipsia, polyuria), erectile dysfunction, decreased libido
investigations for diabetic neuropathy
fasting glucose test, HbA1c, TSH, serum B12, folate, lipid profile, LFT’s, FBC and ESR, electrolytes, urea and creatinine
why is TSH, B12, folate, LFT’s, U&E’s done
to rule out other causes for symptoms such as thyroid dysfunction, deficiencies, renal disease, hepatic disease
why is FBC and ESR done
to rule out inflammatory causes and anaemia
how to treat diabetic peripheral neuropathy without pain
Glycaemic control with supportive measures
treating diabetic peripheral neuropathy with pain
pregabalin or gabapentin. they treat neuropathic pain.
plus Glycaemic control
