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Tests and diagnosis
By Mayo Clinic staffDiabetic neuropathy is usually diagnosed based on your symptoms, your medical history and a physical exam. During the exam, your doctor is likely to check your muscle strength and tone, tendon reflexes, and sensitivity to touch, temperature and vibration.
Other tests that may be conducted include:
- Filament test. Sensitivity to touch may be tested using a soft nylon fiber called a monofilament. If you're unable to feel the filament on your feet, it's a sign that you've lost sensation in those nerves.
- Nerve conduction studies. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It's often used to diagnose carpal tunnel syndrome.
- Electromyography (EMG). Often performed along with nerve conduction studies, electromyography measures the electrical discharges produced in your muscles.
- Quantitative sensory testing. This noninvasive test is used to assess how your nerves respond to vibration and changes in temperature.
- Autonomic testing. If you have symptoms of autonomic neuropathy, your doctor may request special tests to look at your blood pressure in different positions and assess your ability to sweat.
The American Diabetes Association recommends that all people with diabetes have a comprehensive foot exam — either by a doctor or by a foot specialist (podiatrist) — at least once a year. In addition, your feet should be checked for sores, cracked skin, calluses, blisters, and bone and joint abnormalities at every office visit.
If you already have diabetic neuropathy, you'll likely be referred to a podiatrist or other specialist for monitoring and treatment.
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/neuropathies.pdf. Accessed Nov. 19, 2009.
- Feldman EL, et al. Treatment of diabetic neuropathy. http://www.uptodate.com/home/index.html. Accessed Nov. 19, 2009.
- Aring AM, et al. Evaluation and prevention of diabetic neuropathy. American Family Physician. 2005;71:2123.
- Chaudhry V. Peripheral neuropathy. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2907120. Accessed Nov. 19, 2009.
- Tesfaye S. Advances in the management of diabetic peripheral neuropathy. Current Opinion in Supportive and Palliative Care. 2009;3:136.
- Standards of medical care in diabetes, 2009. American Diabetes Association. Diabetes Care. 2009;32(suppl):13.
- Masharani U, et al. Pancreatic hormones and diabetes mellitus. In: Gardner DG, et al. Greenspan's Basic and Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aID=2633151. Accessed Nov. 19, 2009.
- Veves A. Painful diabetic neuropathy: Epidemiology, natural history, early diagnosis, and treatment options. Pain Medicine. 2008;9:660.
- Diabetic neuropathies. American Diabetes Association. Diabetes Care. 2005;28:956.
- Robertson CB (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2009.
- ACCORD study group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. New England Journal of Medicine. 2010. http://content.nejm.org/cgi/content/full/NEJMoa1001286. Accessed March 15, 2010.
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