A 10-yrs-old girl with type I diabetes develops a neuropathy limited to sensory neurons with free nerve endings. Quantitative sensory testing will reveal higher-than-normal thresholds for the detection of which of the following?
**Core Concept**
Type I diabetes mellitus can lead to diabetic neuropathy, a complication affecting sensory neurons with free nerve endings. This neuropathy is characterized by damage to the peripheral nerves, resulting in impaired sensation and altered nerve function.
**Why the Correct Answer is Right**
The neuropathy in this patient is likely a result of damage to the small, unmyelinated nerve fibers responsible for transmitting pain and temperature sensations. Quantitative sensory testing will reveal higher-than-normal thresholds for detecting these sensations, particularly for heat and cold. This is because the damaged nerve fibers are unable to transmit signals efficiently, leading to an increased threshold for sensation.
**Why Each Wrong Option is Incorrect**
**Option A:** Touch sensation is mediated by large myelinated nerve fibers, which are not primarily affected in this type of neuropathy. Thus, touch sensation may not be significantly impaired.
**Option B:** Proprioception and vibration sensation are primarily mediated by large myelinated nerve fibers, which are not primarily affected in this type of neuropathy. Thus, these sensations may not be significantly impaired.
**Option C:** Motor function is mediated by large myelinated nerve fibers, which are not primarily affected in this type of neuropathy. Thus, motor function may not be significantly impaired.
**Clinical Pearl / High-Yield Fact**
Diabetic neuropathy is a common complication of type I diabetes mellitus, affecting up to 50% of patients. It is often asymptomatic until significant nerve damage has occurred, highlighting the importance of regular monitoring and early detection.
**Correct Answer:** C. Cold (and heat)