How are diabetic neuropathies diagnosed?

Doctors diagnose neuropathy on the basis of symptoms and a physical exam,During the exam,your doctor may check blood pressure ,heart rate,muscle strength,reflexes,and sensitivity to position changes,vibration,temperature,or light touch.
Foot Exams
Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy.People diagnosed with peripheral neuropathy need more frequent foot exams.A comprehensive foot exam assesses the skin.
mmuscles,bones,circulation,and sensation of the feet.Your doctor may assess protective sensation or feeling in your feet by touching your foot with a nylon monofilament--similar to a bristle on a hairbrush--attached to a wand or by pricking your foot with a pin.People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly.The doctor may also check temperature perception or use a tuning fork,which is more sensitive than touch pressure, to assess vibration perception.
Other Tests
The doctor may perform other tests as part of your diagnosis.

• Nerve conduction studies or electromyography are sometimes used to help determine the type and extent of nerve damage.Nerve conduction studies check the transmission of electrical current through a nerve.
• Electromyography shows how well muscles respond to electrical signals transmitted by nearby nerves.These tests are rarely needed to diagnose neuropathy.
• A check of heart rate variability shows how the heart responds to deep breathing and to changes in blood pressure and posture.
• Ultrasound uses sound waves to produce an image of internal organs.An ultrasound of the bladder and other parts of the urinary tract,for example,can show how these organs preserve a normal structure and whether the bladder empties completely after urination.