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Diabetic Polyneuropathy

Samir Malkani, MD, MRCP–UK Reviewed 06/2019
 


BASICS

DESCRIPTION

Peripheral nerve dysfunction seen in diabetes; several patterns described (1): 
  • Symmetric polyneuropathy

    • Distal sensory or sensorimotor

  • Mononeuropathy, radiculopathy, and polyradiculopa...

DIAGNOSIS

HISTORY

  • Most common form (typical): symmetric distal sensory or sensorimotor polyneuropathy

    • Distressing numbness, tingling, pain of legs/feet, usually worse at night; allodynia; hyperalgesia

    • Of...

TREATMENT

GENERAL MEASURES

  • Maintain blood glucose close to normal.

  • Provide appropriate footwear to prevent pressure damage to insensate feet.

MEDICATION

First Line

Management of pain and sensory neuropathy...

ONGOING CARE

PROGNOSIS

  • Generalized symmetric polyneuropathies

    • Usually slow, chronic progression

    • Insensitive but painless foot as pain lessens

  • Focal neuropathies

    • Recovery over months to years

COMPLICATIONS

  • Cl...

REFERENCES

1
Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care.  2017;40(1):136–154. [View Abstract on OvidM...

ADDITIONAL READING

CODES

ICD10

  • E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy

  • E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy

  • E13.42 Oth diabetes mellitus with diabetic polyneuropathy

  • E08.42 Diabe...

CLINICAL PEARLS

  • Occasionally, when glycemic control improves dramatically, as can occur when treatment for diabetes is initiated, there may be a worsening of neuropathy symptoms (described as treatmen...

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