Diabetic Neuropathy

Examinations and Tests

A diagnosis of diabetic neuropathy is based largely on your symptoms, medical history, and neurologic examination. During a neurologic examination, your doctor will check how well you feel touch and temperature. Your doctor will also check your strength and reflexes. Electromyogram (EMG) and nerve conduction studies may be done to confirm a diagnosis. These tests measure how well and how quickly the nerves and muscles conduct electrical impulses. When nerve damage is present, the speed of nerve function slows.

Problems associated with autonomic neuropathy—which affects the nerves that control internal functions—can be difficult to diagnose. When new symptoms develop, further testing may be needed to diagnose the problem, identify the cause, and guide treatment. For example, a study that measures how fast your stomach empties may be done if symptoms like bloating, indigestion, or vomiting suggest gastroparesis, a condition that causes the stomach to take too long to empty.

Nerve problems in people with diabetes may be caused by other conditions, such as kidney disease, alcohol dependence, or a vitamin B12 deficiency. A variety of laboratory tests (such as a complete blood count) may be used to screen for conditions other than diabetes that could be causing symptoms. Your symptoms and medical history will determine which tests are needed.

Early Detection

For some diseases, doctors can use screening tests to look for problems before you have any symptoms. But doctors cannot test for all types of autonomic or focal neuropathy. So it is important to report to your doctor any pain, weakness, or motor problems you have. Also mention any changes in digestion, urination, sexual function, sweating, or dizziness. Your doctor will also look for signs of autonomic neuropathy during your physical examinations.

Screening for peripheral neuropathy can help prevent foot ulcers and amputation. The Canadian Diabetes Association (CDA) recommends people with diabetes see a health professional to examine their feet for cracked or peeling skin, excessive or reduced sweating, blisters, calluses, ulcers, signs of infection, bone and joint abnormalities, and walking and balance during each medical visit. The CDA also recommends a complete foot examination by a health professional at least once a year, or more often if you are at risk of having foot problems, such as if you have neuropathy or had foot problems before.² This examination can detect a loss of sensation in your feet, which can lead to more serious foot problems.

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Author:	Carrie Henley Monica Rhodes	Last Updated: July 28, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Tom Bailey, MD - Family Medicine Barrie J. Hurwitz, MD - Neurology
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