Diabetic Polyneuropathy: Definitive Diagnosis

DPN can present with a wide range of symptoms, including pain, unsteadiness, weakness, postural hypotension, gastroparesis, and impotence. It can lead to foot ulceration, Charcot foot, and amputation. It is desirable to periodically assess for the presence of neuropathy and also stratify neuropathy in patients in anticipation of these problems. It is important to be aware of the strengths and limitations of the different tests used to assess DPN and their abilities to demonstrate a meaningful change in peripheral neuropathy. Also, because not all patients with an abnormality will show clinically significant disease, it is important to know to what degree the test results are altered from normal.2 CLASSIFICATION OF DIABETIC NEUROPATHY Diabetic neuropathy can be classified as acute sensory and chronic sensorimotor. Acute sensory neuropathy. Acute sensory (painful) neuropathy is distinguished from chronic sensorimotor neuropathy by the mode of onset, accompanying signs, and prognosis (Table 1).3,4 Severe pain is the main complaint and is often associated with significant weight loss and depression and erectile dysfunction in men.