Clinical Diagnosis of Diabetic Neuropathy

Abstract

Diabetic neuropathies are among most common long-term complications of diabetes. Clinical assessment of diabetic neuropathies typically involves evaluation of subjective symptoms and neurological deficits since an alteration in the former does not necessarily reflect an improvement in nerve function. A number of clinical symptom and/or deficit scales have been developed for either mass screening, or focused research put-poses. The assessment may additionally be quantified using more or less sophisticated tools. The Semmes-Weinstein monofilaments and graduated tuning fork can detect patients with advanced neuropathy, while quantitative sensory testing and nerve conduction studies are much more sensitive to subtle changes in nerve function. Sophisticated techniques like axon reflex, magnetic resonance imaging and corneal confocal microscopy are rarely used outside research environment. Recent years have brought a significant progress in symptomatic treatment of painful diabetic neuropathies. However, an effective treatment of the underlying pathology is still lacking.