Diabetic neuropathy: Diagnostic methods

Screening and diagnostic testing for neuropathy in patients with type 1 or type 2 diabetes is needed in order to prevent complications from diabetic neuropathy. As diabetic neuropathy frequently leads to foot ulcers and amputation— major causes of morbidity and disability in people with diabetes—the American Diabetes Association recommends an annual foot exam for people with diabetes in order to identify those with high-risk foot conditions. Yet, detection and diagnosis of diabetic neuropathy can be complex. The diagnosis of neuropathy is based on both clinical and objective measures. Medical and neurological history, physical and neurological examination (evaluating sensory, motor, reflex, and autonomic function), and measurement of peripheral nerve function by clinical testing have been used and then combined into a series of clinical assessment scores that screen for and quantify the severity of diabetic neuropathy. No fewer than 12 clinical assessment scoring systems are available. This article presents the tools and methods commonly used to screen and diagnose neuropathy in patients with diabetes and discusses issues surrounding their use. (Adv Stud Med. 2004;4(8A):S650-S661) D