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Diabetic neuropathy — SCE Endocrinology MCQ

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EasyDiabetesDiabetic neuropathySCE Endocrinology

A 53-year-old woman with type 2 diabetes has painful burning feet, worse at night. Vibration sense is reduced and ankle reflexes are absent. Foot pulses are palpable and monofilament sensation is reduced. What is the most likely diagnosis?

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Correct answer: C — Painful distal symmetrical diabetic neuropathy

The bilateral stocking distribution pain with sensory loss is typical of distal symmetrical diabetic neuropathy. Charcot usually presents with a hot swollen foot rather than nocturnal burning pain. Palpable pulses make critical ischaemia less likely, although vascular assessment remains important in diabetes.

Reference: NICE NG19; NICE NG28