In a client with long-standing type 1 diabetes and poor past management, which finding is most likely to be identified during assessment?

In a client with long-standing type 1 diabetes and poor past management, which finding is most likely to be identified during assessment?

• A. Leg ulcers
• B. Decreased sensation in the feet
• C. Loss of visual acuity
• D. Thick, yellow toenails

Answer: (B)

Long-standing diabetes with poor control commonly causes diabetic peripheral neuropathy, where chronic high blood glucose damages nerves—especially the longest ones in the legs and feet. This leads to decreased protective sensation in the feet, so patients may not feel injuries, pressure, or small wounds. That sensory loss is a typical and early finding on assessment for someone with years of unmanaged diabetes. Other diabetes-related changes can occur, like visual changes from retinopathy or difficult toenail infections, but the most likely finding in this scenario is reduced sensation in the feet due to nerve damage.

Long-standing diabetes with poor control commonly causes diabetic peripheral neuropathy, where chronic high blood glucose damages nerves—especially the longest ones in the legs and feet. This leads to decreased protective sensation in the feet, so patients may not feel injuries, pressure, or small wounds. That sensory loss is a typical and early finding on assessment for someone with years of unmanaged diabetes.

Other diabetes-related changes can occur, like visual changes from retinopathy or difficult toenail infections, but the most likely finding in this scenario is reduced sensation in the feet due to nerve damage.