Diagnosis of diabetic peripheral neuropathy—clinical practice and research

Andrew J M Boulton

in Diabetic Neuropathy

Published on behalf of Oxford University Press

ISBN: 9780199551064
Published online May 2011 | e-ISBN: 9780199607303 | DOI:

Series: Oxford Diabetes Library

Diagnosis of diabetic peripheral neuropathy—clinical practice and research

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• Diabetic peripheral neuropathy (DPN) is a clinical diagnosis in day-to-day practice; it is a diagnosis of exclusion of other causes and a simple history and clinical examination are the essential components. • As up to 50% of patients may be asymptomatic the diagnosis cannot be made on history alone. • For clinical research, the diagnosis of DPN requires at least two tests in addition to the clinical history and examination: these normally comprise quantitative sensory testing (QST) and electrophysiology (EP). • Although EP remains the gold standard for clinical research in DPN, promising new techniques include skin biopsy and confocal corneal microscopy (CCM). • Peripheral sympathetic autonomic neuropathy can lead to a warm, dry foot in the absence of peripheral vascular disease. For clinical research, tests such as galvanic skin resistance or the newer Neuropad® may be used.

Chapter.  2998 words. 

Subjects: Neurology

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