Situation: A patient with painful diabetic neuropathy came with postural hypotension.
Dr Bad: The two are unrelated conditions.
Dr Good: It is due to autonomic dysfunction.
Lesson: Painful diabetic neuropathy is associated with significantly greater autonomic dysfunction than painless diabetic neuropathy. The greater autonomic dysfunction seen in painful diabetic peripheral neuropathy (DPN) may reflect more predominant small fiber involvement and also adds to the growing evidence of its role in the pathophysiology of painful DPN
(Diabetes Care 2010;33(7):1585-90).
Dr Bad: The two are unrelated conditions.
Dr Good: It is due to autonomic dysfunction.
Lesson: Painful diabetic neuropathy is associated with significantly greater autonomic dysfunction than painless diabetic neuropathy. The greater autonomic dysfunction seen in painful diabetic peripheral neuropathy (DPN) may reflect more predominant small fiber involvement and also adds to the growing evidence of its role in the pathophysiology of painful DPN
(Diabetes Care 2010;33(7):1585-90).
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