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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. 10, 2011.
- Feldman EL, et al. Treatment of diabetic neuropathy. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2011.
- Bril V, et al. Evidence-based guideline: Treatment of painful diabetic neuropathy: Report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnosticc Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2011;76:1758.
- Ultram (tramadol hydrochloride), Ultracet (tramadol hydrochloride/acetaminophen): Label change. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213264.htm. Accessed Nov. 20. 2011.
- Neuropathy (nerve damage). The American Diabetes Association. http://www.diabetes.org/living-withdiabetes/complications/neuropathy/. Accessed Nov. 21, 2011.
- Standards of medical care in diabetes, 2011. American Diabetes Association. Diabetes Care. 2011;34(suppl):11.
- Kidney disease (neuropathy). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html. Accessed Nov. 21, 2011.
- Amato AA, et al. Peripheral neuropathy. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: McGraw-Hill Medical; 2012. http://www.accessmedicine.com/content.aspx?aID=9148461. Accessed Nov. 21, 2011.
- Diabetic neuropathy. The AGS Foundation for Health in Aging. http://www.healthinaging.org/public_education/diabetes/neuropathy.php. Accessed Nov. 21, 2011.
- Diabetic neuropathies. American Diabetes Association. Diabetes Care. 2005;28:956.
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