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Diabetic peripheral neuropathy — MCCQE Part 1 MCQ

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EasyNumbness/TinglingDiabetic peripheral neuropathyMCCQE Part 1

A 62-year-old man has progressive symmetric distal sensory loss (glove-and-stocking), absent ankle reflexes, and burning feet x 2 years. HbA1c 69 mmol/mol. Most appropriate management of neuropathy?

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Correct answer: A — Optimise glycaemic control plus pregabalin or duloxetine for neuropathic pain

Diabetic peripheral neuropathy: glycaemic control slows progression. Pregabalin, duloxetine, gabapentin first-line for neuropathic pain (CANMAT/Diabetes Canada). Foot care essential to prevent ulceration.

Reference: Diabetes Canada CPG / CPA Pain Guidelines