Diagnosis and management of diabetic peripheral neuropathy

Diabetic peripheral neuropathy (DPN) is one of the most commonly occurring major complications of diabetes. The disease may manifest in several clinic al patterns: most frequently as distal symmetrical sensory polyneuropathy. Guidelines are available for the diagnosis of DPN by the primary care physi cian. These recommend that a review of diabetic patients, including a quest ionnaire and inspection and neurological examination of the feet, is undert aken annually. Techniques used for studying the disease process in clinical trials may include nerve conduction and quantitative sensory function test s, autonomic nervous system testing, post-ganglionic sudomotor function and skin biopsy. Current therapies for managing DPN are strict glycaemic contr ol, palliative treatments and foot ulcer prevention. Future treatments aim to beneficially affect the underlying disease pathology and putative agents are currently being investigated.