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Diabetic Neuropathy — RACP Adult Medicine MCQ

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EasyEndocrinologyDiabetic NeuropathyRACP Adult Medicine

A 55-year-old man with a 20-year history of type 2 diabetes presents with bilateral burning pain and numbness in a stocking distribution. Vibration and temperature sensation are reduced in the feet. Ankle reflexes are absent. Nerve conduction studies show a length-dependent axonal sensorimotor polyneuropathy. HbA1c is 80 mmol/mol. What is the most likely diagnosis?

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Correct answer: A — Diabetic peripheral neuropathy

Length-dependent axonal sensorimotor polyneuropathy in a patient with longstanding poorly controlled diabetes is diabetic peripheral neuropathy. It is the commonest cause of peripheral neuropathy worldwide. Glycaemic optimisation is the primary treatment. Neuropathic pain management includes pregabalin, duloxetine, or amitriptyline as first-line agents.

Reference: ADS – 2024 – Diabetic Neuropathy; eTG Neurology 2024