DIAGNOSTIC INVESTIGATION AND THERAPY OF D IABETIC

Distinction is made between peripheral and autonomic neuropathy. The f ormer is usually painful, while the latter is especially associated wi th cardiovascular, gastrointestinal and urogenital disturbances. In th e diagnosis of peripheral neuropathy, a basic neurological examination (reflex status, vibratory sense) takes precedence over measuring the velocity of nerve conduction and determining the temperature and pain thresholds. The diagnostic approach to the automining the temperature and pain thresholds. The diagnostic approach to the autonomic disturba nces is organ-specific (testing of cardiovascular reflexes, sonographi c and scintigraphic determination of gastric emptying, infusion urogra phy and uroflowmetry). Early diagnosis and optimal diabetes control ar e the therapeutic consequences. Symptomatic treatment includes the adm inistration of analgesics, antidepressants and carbamazepine. A newer drug being currently tried is mexiletine. High doses of alpha-liponic acid as well as the fat-soluble B vitamins are used for causal therapy . Clinical trials with aldose reductase inhibitors and gamma-linolenic acid are under way.