Dibaetic Neuropathy

Question 1

What type of loss does diabetes typically lead to?

Answer 1

Sensory loss

Motor loss is not typically associated with diabetes.

Question 2

What is the distribution pattern of sensory loss in diabetes?

Answer 2

‘Glove and stocking’ distribution

This pattern indicates that the lower legs are affected first due to the length of the sensory neurons.

Question 3

What is a common problem associated with diabetic neuropathy?

Answer 3

Painful diabetic neuropathy

This condition is frequently encountered in clinical practice.

Question 4

What did NICE update in 2013 regarding neuropathic pain management?

Answer 4

Diabetic neuropathy is managed like other forms of neuropathic pain

This includes using specific medications as first-line treatments.

Question 5

What are the first-line treatment options for diabetic neuropathy?

Answer 5

• Amitriptyline
• Duloxetine
• Gabapentin
• Pregabalin

These medications are used to manage neuropathic pain effectively.

Question 6

What should be done if the first-line drug treatment for diabetic neuropathy does not work?

Answer 6

Try one of the other 3 drugs

This approach ensures that patients receive alternative options for pain management.

Question 7

What medication may be used as ‘rescue therapy’ for exacerbations of neuropathic pain?

Answer 7

Tramadol

This medication provides additional support during painful episodes.

Question 8

What topical treatment can be used for localized neuropathic pain?

Answer 8

Topical capsaicin

This is effective for conditions like post-herpetic neuralgia.

Question 9

What may be useful for patients with resistant neuropathic pain problems?

Answer 9

Pain management clinics

These specialized clinics can provide targeted care for difficult cases.

Question 10

What condition occurs secondary to autonomic neuropathy?

Answer 10

Gastroparesis

This condition affects gastric motility and can lead to various symptoms.

Question 11

What are the symptoms of gastroparesis?

Answer 11

• Erratic blood glucose control
• Bloating
• Vomiting

These symptoms can significantly impact patient quality of life.

Question 12

What management options are available for gastroparesis?

Answer 12

• Metoclopramide
• Domperidone
• Erythromycin

These are prokinetic agents that help improve gastric emptying.

Question 13

What gastrointestinal issue often occurs at night in diabetic patients?

Answer 13

Chronic diarrhoea

This can be a troublesome symptom affecting sleep and comfort.

Question 14

What is the cause of gastro-oesophageal reflux disease (GERD) in diabetic patients?

Answer 14

Decreased lower esophageal sphincter (LES) pressure

This leads to reflux symptoms and discomfort.