The diagnosis of diabetic sensory neuropathy is made based on review of the signs and symptoms, the results of the physical examination and diagnostic studies. Dr. Lavery reminds us that the use of a single instrument (Semmes-Weinstein monofilaments, for example), is not sufficient to make a definitive diagnosis. Patients with nutritional deficiencies, anemia, radiculopathies, alcoholism and other conditions present with symptoms very similar to diabetic sensory neuropathy.

Dr. Lavery reviews the various screening tests that will help the practitioner make a correct diagnosis. Standard vibration perception, deep tendon reflexes, motor strength, sharp/dull discrimination and light touch should all be part of the initial examination. While these tests are valuable, their results are difficult to quantify.

The biothesiometer is a unique device which can provide semi-quantitative information about the level of vibration the patient can feel in their foot. The information gleaned from this device helps us better understand the benefits and effectiveness of our treatment.

The first step in the management of established diabetic neuropathy is to maintain good glycemic control. Patients who have undergone pancreatic transplantation have seen significant reversal in the neuropathy.

Monochromatic Near-Infrared Therapy, commonly known as Anodyne, has shown great promise. 98% of patients who received Anodyne Therapy for thirty minutes, three times weekly, had improvement after six weeks. The percentage of patients who saw improvement increased to one hundred percent, after twelve weeks of treatment. Dr. Lavery also discusses surgical decompression. This technique has shown great promise.  However, he feels that more research is needed before it is used on a widespread basis in this high risk population.

Be aware - The answer to the question, "Can you do anything for the numbness and burning in my foot?", is rapidly changing.
 

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