Neuropathy Diabetic Neuropathy 1 — Questions and Answers
Question 1: What is the most common form of diabetic neuropathy?
- Autonomic neuropathy
- Proximal neuropathy
- Distal symmetric polyneuropathy (Correct answer)
- Focal mononeuropathy
Correct answer: Distal symmetric polyneuropathy
Distal symmetric polyneuropathy is the most prevalent form, affecting the feet and hands in a stocking-glove pattern.
Question 2: The stocking-glove pattern of sensory loss in diabetic neuropathy reflects damage to which fiber types first?
- Large myelinated fibers only
- Small unmyelinated C fibers and Aδ fibers first (Correct answer)
- Motor fibers only
- Cranial nerve fibers
Correct answer: Small unmyelinated C fibers and Aδ fibers first
Small nerve fibers (C and Aδ) are damaged early in diabetic neuropathy, causing pain and temperature loss before large-fiber signs appear.
Question 3: Which HbA1c target is recommended to slow the progression of diabetic neuropathy in non-elderly adults with type 1 diabetes?
- Below 9%
- Below 8%
- Below 7% (Correct answer)
- Below 6%
Correct answer: Below 7%
Maintaining HbA1c below 7% significantly reduces the risk and progression of diabetic peripheral neuropathy.
Question 4: Diabetic amyotrophy (proximal neuropathy) most characteristically presents with which symptom?
- Bilateral foot tingling
- Severe unilateral thigh pain and weakness (Correct answer)
- Foot drop
- Loss of ankle reflexes only
Correct answer: Severe unilateral thigh pain and weakness
Diabetic amyotrophy presents with acute, severe, often unilateral pain and weakness in the proximal leg muscles.
Question 5: Which first-line medication is FDA-approved for painful diabetic peripheral neuropathy?
- Gabapentin
- Pregabalin (Correct answer)
- Amitriptyline
- Carbamazepine
Correct answer: Pregabalin
Pregabalin (Lyrica) is FDA-approved for painful diabetic peripheral neuropathy and has strong clinical trial evidence.
Question 6: In diabetic neuropathy, loss of the Achilles tendon reflex indicates damage to which nerve root level?
- L2-L3
- L4-L5
- S1-S2 (Correct answer)
- L1-L2
Correct answer: S1-S2
The Achilles reflex is mediated by the S1 nerve root via the tibial nerve, and its absence is an early sign of diabetic polyneuropathy.
Neuropathy Diabetic Neuropathy 1
What is the most common form of diabetic neuropathy?