distal symmetric polyneuropathy:
-most common form of diabetic neuropathy
-mostly presents w/ distal sensory loss and pain, but up to 50% do not have symptoms of neuropathy.
-Hyperesthesia, paresthesia, and dysesthesia may occur.
-Symptoms: a sensation of numbness, tingling, sharpness, or burning that begins in feet and spreads proximally
-Neuropathic pain develops in some, occasionally preceded by improvement in their glycemic control; typically involves lower extremities, u. present at rest, and worsens at night. Both an acute (lasting <12 months) and a chronic form: acute form sometimes treatment-related;
-As neuropathy progresses, pain subsides and eventually disappears, but a sensory deficit in lower extremities persists.
-P/E examination: sensory loss, loss of ankle deep-tendon reflexes, and abnormal position sense.