Clinical management of the painful diabetic neuropathies.

340 Journal of the Royal College of Physicians of London Vol. 34 No. 4 July/August 2000 The neuropathies of diabetes are common, affecting up to 50% of older patients with type 2 diabetes. They have been the subject of several recent reviews1–3. Only a minority of patients experience neuropathic symptoms, so the absence of symptoms must never be equated with the absence of neuropathy1–3. A careful clinical examination of the lower limbs and feet is essential to diagnose neuropathy in any diabetic patient.