Study Map for: Diabetic Neuropathy

Pathophysiology: Risk Factors Treatment Outcomes: (meds, surgical procedures, etc.)

Diabetic neuropathy is nerve Non-modifiable: The only treatment is control of blood glucose.
damage that occurs due to Type 1 DM Medications such as topical creams, tricyclic antidepressants, and
metabolic derangements antiseizure medications can be used to treat neuropathic symptoms (i.e.
associated with diabetes Modifiable: pain)
mellitus. Poor glycemic control
Sensory neuropathy affects Smoking
hands, feet, or both bilaterally. Heavy alcohol intake Actual/Potential Risks from treatments or procedures:
Autonomic neuropathy can affect Risk of hypoglycemia as a result of tx DM.
all body systems
Etiology is not well understood.

Diagnosis
Disease Complication(s):
Peripheral sensory neuropathy is 1. Diagnostic Tests:
the most common neuropathy Note: Tests would be done for DM NURSING MANAGEMENT:
that can lead to the loss of Fasting plasma glucose (FPG) Priority
protective sensation in the lower Glucose tolerance test System(s)
extremities. This neuropathy Hemoglobin A1C
increases the risk for Assess Assess for signs of hyperglycemia and hypoglycemia
complications that result in lower Assess the pt’s current knowledge and understanding of
limb amputation. disease

Autonomic neuropathy can 2. Laboratory Tests:

cause gastric emptying as a Complete blood count
complication, as well as lead to
hypoglycemic unawareness,
bowel incontinence and diarrhea,
and urinary retention
Presentation: (signs and Consults: (to consider with this disease
symptoms) process) Do Prioritize glycemic control to slow the progression of
Sensory Neuropathy: Physical therapist – to address the (prioritize) neuropathy.
- Paresthesia muscular pain and weakness caused by Management of diabetic neuropathy such as foot care, tight
- Abnormal sensations the disease glycemic control, and pain management
- Pain Occupational therapist – in the case of Provide therapies for symptomatic relief and those that
- Loss of sensation amputation, OT can address the severe possibly slow the progression of neuropathy.
Autonomic Neuropathy: loss of functional status
- Anorexia Endocrinologist – can assist in diabetes Teach Educate pt about acute and chronic complications of
- N/V management diabetes.
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 - Gastro-esophageal reflux Neurologist – consult early in course of Teach the importance of involving a neurologist.
- Persistent feelings of neuropathy Teach proper glycemic control and importance it has to
fullness slowing progression of neuropathy
Evaluation

Growth and Development Impacts Psychosocial Implications and Concerns (Holistic)

Diabetic neuropathy can occur at any age; however, it is more common with Must address the pt’s support systems and coping mechanisms for the
increasing age, severity, and duration of DM disease’s complications

Additional Notes:
Lewis, S. L., Bucher, L., Heitkemper, M.M., Harding, M.M., Barry, M. A., Lok, J.L., Tyerman, J., Goldsworthy, S. (Eds). (2019). Medical-surgical nursing in
Canada: Assessment and management of clinical problems (4th Canadian ed.). Toronto, ON: Elsevier. ISBN: 9781771720489

Unbound Medicine. (2018). Nursing Central (Version 1.35) [Mobile application software]. Retrieved from http;//itunes.apple.com

Quan, D. (2018). Diabetic Neuropathy. Medscape. Retrieved from: https://emedicine.medscape.com/article/1170337-overview#a2

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