Diabetic Neuropathy Công cụ chẩn đoán

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_Diagnotics

Imaging

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