Content on this page:
Content on this page:
Laboratory Tests and Ancillaries
Lab tests that can be
performed in the evaluation of diabetic neuropathy includes complete blood
count (CBC), metabolic panel (includes creatinine, erythrocyte sedimentation
rate [ESR]), serum vitamin B12, folic acid tests, thyroid function tests, and
serum protein immunoelectrophoresis. It must be noted that regular screening
for vitamin B12 deficiency is recommended by the American Diabetes Association
(ADA) in patients with DM taking Metformin, as Metformin can lead to vitamin
B12 deficiency.
Ancillary Tests
Tests for the
diagnosis of peripheral sensory neuropathy include nerve conduction studies,
electromyography, nerve biopsy, and intraepidermal nerve fiber density biopsy.
Intraepidermal nerve fiber density biopsy assesses small fiber function but
requires invasive skin biopsy.
Diabetic Neuropathy_DiagnoticsImaging
Tests for PAD:
- Doppler ultrasound with pulse volume recordings
- Toe systolic BP
determination is more accurate than ABI
- Toe systolic BP <30 mmHg is suggestive of PAD and requires further vascular evaluation
- Screening for PAD with the use of non-invasive arterial tests is recommended for patients with DM and >50 years of age