Neuropathy is a common complication of diabetes affecting up to 50% of people who have had diabetes more than 25 years. It classically presents as symmetrical loss of sensation in the feet but may also present with pain or unpleasant alteration of touch sensation (allodynia) in the feet. In addition to peripheral neuropathy, other manifestations include autonomic neuropathy and diabetic mono-neuropathies.


An essential baseline when considering any diabetes complication.

Vitamin B12

Pernicious anaemia and sub acute combined degeneration of the cord is an important differential diagnosis of diabetic peripheral neuropathy.


Uraemic neuropathy is a differential that should be considered.


Myxoedematous peripheral neuropathy is a differential that should be considered.

HIV test

If there are risk factors then an HIV test should be offered.

Nerve conduction studies

These are rarely helpful in the case of a classical diabetic peripheral neuropathy but can be useful in suspected mono neuropathy, such as median or ulnar nerve entrapment.

Diabetesbible is for health professionals