How to diagnose neuropathy in diabetes mellitus?

Abstract

Diabetic neuropathy is a common problem and can present various clinical presentations such as cranialneuropathy, radiculopathy, plexopathy, mononeuropathy, polyneuropathy and autonomic neuropathy. Clinicalevaluation and use of scoring systems for the evaluation of diabetic polyneuropathy is an important step to getcorrect diagnosis. New informations about the diagnosis of diabetic neuropathy continue to emerge, whichwill lead to correct diagnosis and treatment as well. Diabetic length-dependent sensorimotor polyneuropathy(DSPN) and carpal tunnel syndrome are the most common seen problems. While acute and painful situationswith motor weakness are mostly transient, sensory fibres are predominantly involved in chronic ones. Nerveconduction studies are needed to confirm diagnosis of any type of diabetic neuropathy, but they are normal incases with small fiber involvement. The early diagnosis is crucial because it is well-known that subclinicaldiabetic neuropathy may be reversed or significantly improved with diabetes control. Because neuropathy atthe stage in which only small fibers are affected can be reversed, it is important to diagnose DSPN in thesestages. Skin biopsy taken from the dermatomal area of sural nerve, laser-doppler-imager flare technique, cornealconfocal microscopy are used to assess small fibre dysfunction. The aim of the present review was to evaluateevidence-based diagnosis for any type of neuropathy seen in the patients with diabetes mellitus