Abstract
Diabetic neuropathy is a significant complication of chronic diabetes. We wished to discover whether we were successfully identifying patients who had developed neuropathic problems. Specifically, Diabetologists are traditionally poor at asking about erectile dysfunction (ED) and patients themselves are not always forthcoming as it an embarrassing medical problem. We targeted all patients attending diabetes review clinics over a 4-month period in two hospitals and asked them to complete an anonymous, self-reported questionnaire after their consultation with the diabetologist or diabetes specialist nurse. Whilst most aspects of diabetic neuropathy are routinely screened for in the diabetes clinic we found that the neuropathic symptoms of both ED and gastroparesis were not commonly enquired about, and that erectile failure was found to be more prevalent than previously. Diabetologists need to be more thorough in their assessment of diabetic neuropathy. This is especially of import with regards to ED because we often shy away from enquiring into such a personal area and male patients rarely highlight the issue due to embarrassment. Our post consultation questionnaire has now been modified to form a useful preconsultation neuropathy screening tool and this is undergoing validation.
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Acknowledgments
Many thanks to Dr. Andrew Gorsuch and Dr. Jeremy Bending for their work with the DRC.
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Appendices
Appendix 1: Post consultation questionnaire
Diabetes review clinic: patient survey
In the diabetes department, we are constantly trying to improve our service to patients. We would be grateful if you could fill in this short questionnaire after your clinic appointment and hand it in to the receptionist.
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Please tick on the left if you were asked about any of the following during your appointment with the doctor today.
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Please tick on the right if you actually do have any problems listed below.
Appendix 2: Preconsultation neuropathy screening tool. C. The author
Neuropathic history
Please take a few minutes to answer the questions below about some signs and symptoms that may have arisen secondary to your diabetes. Tick yes or no based on how you usually feel.
No | Yes | ||
---|---|---|---|
1. | Are your legs and/or feet numb? | (1) | (2) |
2. | Do you ever have any burning pains or pins and needles in your legs and/or feet? | (1) | (2) |
3. | Do you full awareness of having very low blood sugar levels (hypoglycaemia)? | (1) | (2) |
4. | Difficulty standing or dizziness on standing? | (1) | (2) |
5. | Persistent sickness or vomiting, constipation or diarrhoea? | (1) | (2) |
6. | Problems with urination? | (1) | (2) |
7. | Problems with having an erection? | (1) | (2) |
8. | Problems with vaginal dryness? | (1) | (2) |
9. | Excessive sweating? | (1) | (2) |
10. | Difficulty seeing in low light conditions (night blindness)? | (1) | (2) |
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Grant, P.S., Lipscomb, D. How often do we ask about erectile dysfunction in the diabetes review clinic?. Acta Diabetol 46, 285–290 (2009). https://doi.org/10.1007/s00592-008-0084-1
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DOI: https://doi.org/10.1007/s00592-008-0084-1