Endocrine & metabolic · UKMLA & AKT
Diabetic neuropathy
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Most common complication of diabetes - distal symmetrical polyneuropathy (DSPN) affects ~50% of type 2 diabetics after 10 years
- Up to 50% of those with polyneuropathy are asymptomatic - always examine, do not just ask
- DSPN may already be present in 20-25% of newly diagnosed type 2 diabetics at first presentation
- Smallest fibres (C-fibres, A-delta) affected earliest - burning pain and temperature loss precede vibration sense loss
- Length-dependent dying-back axonopathy - longest nerves (feet) damaged first; glycaemic control can slow progression but cannot reverse established damage
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