Diabetic Neuropathy Diagnosis
Your physician will conduct a medical history, physical exam, and even a pin-prick test to determine if you have diabetic neuropathy.
In diagnosing diabetic neuropathy—also called diabetic nerve damage—your doctor may run a few exams and tests. He or she will also ask you about your symptoms.
All this is done to get an accurate diagnosis. It's important to understand what type of diabetic neuropathy you have (diabetic peripheral neuropathy, proximal neuropathy, autonomic neuropathy, or focal neuropathy), as well as the extent of nerve damage.
When describing your symptoms, be as specific as you can. The different types of diabetic neuropathy affect different nerves and cause different symptoms. Describing the severity and location of your pain (or other symptoms) will also help your doctor make an accurate diagnosis.
Exams and Tests to Diagnose Diabetic Neuropathy
The doctor will most likely perform a physical exam to assess your general physical condition, including your blood pressure, heart rate, reflexes, muscle strength, and ability to move.
A critical part of the physical exam is a comprehensive foot exam. (People with diabetes should have a yearly foot exam.) In diabetic peripheral neuropathy—the most common type of diabetic neuropathy—the nerves in the feet and legs are usually the most damaged. Therefore, it's critical to check your foot health by assessing the circulation, bones, muscles, and skin.
A neurological exam is also important in diagnosing diabetic neuropathy. Using various tests, the doctor will be able to determine how well your nerves are working.
As mentioned before, different nerves transmit different messages; some are in charge of temperature and others deal with touch or vibration. By testing these different types of nerves, your doctor can determine which nerves are damaged.
For example, to test how well your touch nerve fibers are working, your doctor may use flexible nylon filaments to help determine how much pressure you can feel. He or she will use different sizes of filaments; each requires a different amount of pressure to make it bend. If you cannot feel the pressure of the filament, that may indicate diabetic neuropathy.
The doctor may also use a tuning fork on your feet to test your ability to feel the vibration from the tuning fork. If you cannot feel the vibration from the tuning fork, that may indicate diabetic neuropathy.
Nerve Conduction Velocity and Electromyography Tests
Nerve conduction velocity (NCV) and electromyography (EMG) tests are sometimes used to help diagnose diabetic neuropathy.
NCV tests measure how long it takes nerves to transmit signals. Damaged nerves don't transmit messages as quickly as they should.
EMG tests can help assess how well muscles are responding to the signals from nerves. If the nerves going to the muscles are damaged, they won't give clear signals and therefore, the muscles won't respond well.
If you are having difficulty urinating, your physicians may order an ultrasound to assess the health of your bladder.
All of these components—a physical exam, neurological exam, and other tests—can help your doctor make an accurate diabetic neuropathy diagnosis.