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diabetic polyneuropathy
see diabetic neuropathy
Epidemiology:
- most common form of polyneuropathy
Pathology:
- longest nerves are affected most severely
- small & large sensory fiber affected
- distal motor fibers less affected [1]
Clinical manifestations:
- symptoms generally begin in the feet, then ascend up to legs
- later affects hands in stocking-glove distribution
Laboratory:
- hemoglobin A1c in blood
Management:
- glycemic control
- management of modifiable risk factors
- exercise
- management of dyslipidemia
- management of weight, obesity
- frequent foot exams
- antidepressants
- amitriptyline
- venlafaxine
- duloxetine
- paroxetine
- anticonvulsants
- pregabalin
- gabapentin
- valproic acid
- capsaicin topical
General
diabetic neuropathy
polyneuropathy
References
- Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19
American College of Physicians, Philadelphia 2012, 2015, 2018, 2021