USMLE/COMLEX - Step 2 - Diabetic Neuropathy

USMLE/COMLEX - Step 2 - Diabetic Neuropathy Diabetic neuropathy is a chronic complication of diabetes mellitus characterized by nerve damage, which results from hyperglycemia-induced metabolic, vascular, and molecular derangements. Its pathophysiology involves complex mechanisms, including oxidative stress, advanced glycation end products, microvascular damage, and altered nerve cell metabolism, ultimately leading to nerve damage, inflammation, and cell death. Numbness or tingling in the hands or feet Loss of sensation, especially in the feet and legs Burning or sharp pain, especially in the feet and legs Muscle weakness or difficulty moving limbs Loss of balance or coordination Sensory loss, including numbness and tingling in the feet or hands Autonomic dysfunction, affecting involuntary functions such as digestion and bladder function Motor dysfunction, causing muscle weakness or wasting Foot problems due to poor circulation, decreased sensation, and a higher risk of injuries and infections Eye problems, affecting eye movements, double vision, or focusing Nerve conduction studies Electromyography Quantitative sensory testing The treatment of diabetic neuropathy aims to relieve symptoms, slow down the progression of nerve damage, and prevent complications. The treatment options may include the following: 1. Blood sugar control 2. Pain management with medications such as over-the-counter pain relievers, antidepressants, anticonvulsants, and opioids 3. Topical creams such as capsaicin or lidocaine 4. Physical therapy to improve muscle strength, flexibility, and balance 5. Transcutaneous electrical nerve stimulation 6. Surgery in severe cases 7. Management of underlying conditions such as high blood pressure and high cholesterol