Which sensation is commonly affected early in diabetic peripheral neuropathy?

• A. Temperature perception.
• B. Fine touch.
• C. Proprioception.
• D. Taste.

Answer: (B)

Early in diabetic peripheral neuropathy, the long nerves in the feet and hands are most affected, and the large-diameter, myelinated fibers that carry fine touch (as well as vibration and proprioception) start to fail. This causes a noticeable reduction in the ability to feel light touch and texture on the skin, often first in the toes and then the feet. Small fibers that convey temperature and pain tend to be affected later, so these sensations may be preserved early. Taste isn’t part of this neuropathic pattern. Proprioception, also carried by large fibers, may worsen as the condition advances, but the initial and most common early change among these modalities is diminished fine touch.