Diabetic neuropathies are diagnosed by health care professionals based on symptoms and a physical exam. During a physical exam, the doctor will check your blood pressure, heart rate and perform a detailed neurological examination. In the neurological examination, functions such as muscle strength, reflexes and sensitivity to position changes, vibration, temperature, or light touch are checked. If needed some special tests may be done to determine the cause of your symptoms and suggest treatment.
Foot Exams: According to experts, anyone with diabetes should get a foot exam done each year by a doctor or by a foot specialist (podiatrist) to check for peripheral neuropathy. If you are diagnosed with peripheral neuropathy, frequent foot exams will be recommended. During the foot exam, the skin, muscles, bones, circulation and sensation of the feet are checked; your doctor may do a filament test. In this test, protective sensation or feeling in your feet is checked by touching the foot with a nylon monofilament present on a wand or by pricking the foot with a pin. If you cannot feel the pinprick or touch of the monofilament, it suggests that you have lost the protective sensation. This increases your risk of developing foot sores that may not heal properly. Your ability to feel temperature and vibration may also be assessed.
Nerve conduction studies or electromyography: This test is done to determine the type and extent of nerve damage. In this study, the transmission of electrical current through a nerve is assessed. When the test is being done, an image of the nerve impulse is formed on a screen as it transmits an electrical signal. If impulses seem slower or weaker than usual, it is suggestive of damage to the nerve. Your doctor can assess the condition of all the nerves in the arms and legs with this test. Electromyography checks the response of muscle to electrical signals transmitted by nearby nerves. The test is usually performed along with nerve conduction studies. In most people, these tests are not done to diagnose neuropathy.
Autonomic testing: The test assesses the function of autonomic nerves. Heart rate variability (change in heart rate) due to deep breathing, changes in blood pressure and posture may be checked to assess the function of autonomic nerves.
Ultrasound: This painless and non-invasive test uses high-frequency sound waves (which cannot be heard by human ears) to evaluate structures inside the body. The pattern of the echoes produced when the sound waves are reflected from the internal structure creates a picture called a sonogram. The radiologist can differentiate healthy tissues and abnormal pattern on this picture. Ultrasound of the bladder and other parts of the urinary tract can show if the bladder empties completely after urination or not.
Nerve biopsy: If needed, the doctor may take a sample of the nerve tissue for examination. This test is mostly done in research settings.
These are some tests that are done if your doctor suspects autonomic neuropathy. Apart from this, your doctor may refer you to a physician, who specializes in digestive disorders
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