Current And Emerging Tools For Assessing Diabetic Peripheral Neuropathy
Large prospective clinical studies, such as the Diabetes Control and Complications Trial and United Kingdom Prospective Diabetic Study, have shown tight glucose control and euglycemia prevent the onset or slow the progression of diabetic neuropathy. Unfortunately, we usually deal with patients whose hyperglycemia has already caused significant damage to the peripheral nervous system. It is important for clinicians to appreciate the full breadth of diabetic peripheral neuropathy, specifically how the motor and autonomic components contribute to the pathogenesis in addition to the sensory dysfunction. It is also important that we are consistent, objective and reliable with respect to our clinical examination of these patients. The Michigan neuropathy screening instrument provides a simple means to accomplish this task that may help improve your overall evaluation and treatment of patients with diabetes. Dr. Piemontese is a resident with the Temple University Hospital Podiatric Surgical Residency Program at Temple University Hospital in Philadelphia. Dr. Meyr is an Assistant Professor in the Department of Podiatric Surgery at the Temple University School of Podiatric Medicine in Philadelphia. Dr. Steinberg is an Assistant Professor in the Department of Plastic Surgery at the Georgetown University School of Medicine in Washington, D.C. Dr. Steinberg is a Fellow of the American College of Foot and Ankle Surgeons. For further reading, see “How To Diagnose Diabetic Peripheral Neuropathy” in the March 2006 issue of Podiatry Today or “Essential Insights On Managing Symptomatic Diabetic Neuropathy” in the October 2009 issue.