Endocrine & metabolic · UKMLA & AKT
Diabetic neuropathy
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise diabetic neuropathy — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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