A diagnosis of diabetic neuropathy is based largely on your symptoms, medical history and physical examination. During a physical exam, your doctor may check how well you feel light touch, temperature, pain, vibration, and movement. Your doctor may also check your strength and reflexes. Electromyogram (EMG) and nerve conduction studies may be done to confirm a diagnosis. These tests measure how well and how quickly the nerves conduct electrical impulses. When nerve damage is present, the speed of nerve function slows.
Problems linked with autonomic neuropathy-which affects the nerves that control internal functions-can be hard to diagnose. When new symptoms develop, more testing may be needed to diagnose the problem, identify the cause, and guide treatment. For example, a study that measures how fast your stomach empties may be done if symptoms like bloating, indigestion, or vomiting suggest gastroparesis, a condition that causes the stomach to take too long to empty.
Nerve problems in people who have diabetes may be caused by other conditions, such as kidney disease, alcohol dependence, or a vitamin B12 deficiency. A variety of laboratory tests (such as a complete blood count) may be used to screen for conditions other than diabetes that could be causing symptoms. Your symptoms and medical history will determine which tests are needed.
For some diseases, doctors can use screening tests to look for problems before you have any symptoms. But doctors can't test for all types of autonomic or focal neuropathy. So it is important to report to your doctor any pain, weakness, or motor problems you have. Also mention any changes in digestion, urination, sexual function, sweating, or dizziness. Your doctor will also look for signs of autonomic neuropathy during your physical exams.
The American Diabetes Association (ADA) recommends that people who have diabetes see a doctor to examine their feet for cracked or peeling skin, excessive or reduced sweating, blisters, calluses, ulcers, signs of infection, bone and joint abnormalities, and walking and balance-during each medical visit. The ADA also recommends a complete foot exam by a doctor at least once a year.1 This examination can detect a loss of sensation in your feet, which can lead to more serious foot problems.