Diabetic Neuropathy: Medical History and Physical Exam

Topic Overview

When you have diabetic neuropathy, your doctor will get your medical history and may ask you about the following:

• Symptoms
  • What kinds of symptoms are you having?
  • How long you have had the symptoms?
  • What makes them worse?
  • What makes them better?
• Medicines
  • What medicines are you taking? Bring a complete list of medicines that you are taking, or bring the medicines with you.
  • Are you having frequent high blood sugar levels?
  • Are you having frequent low blood sugar levels?
• Lifestyle
  • What kind of physical activity do you get? How often?
  • Do you smoke?
  • Do you drink alcohol?
  • Are you following your diabetes diet?

Your doctor will also give you a physical exam. During the exam, the doctor may check:

• Your response to light touch, pressure, temperature, movement, repositioning, and vibration, particularly in your feet and legs. Simple tests can be used to screen for loss of sensation. The doctor may touch the end of your toe with a cotton wisp or a thin plastic fiber (called a monofilament test) to see whether you sense light touch or pressure. To evaluate your sensation of temperature, a cold metal tuning fork may be held to your leg. A vibrating tuning fork may be touched to your foot to check your sensation of vibration. These tests should be done on both feet.
• Your muscle strength.
• Your reflexes, especially those in your ankles and knees.
• Your blood pressure and pulse and how they change when you are in certain positions (lying down, sitting, standing).

During every visit, your doctor needs to examine your feet for cracked or peeling skin, excessive or reduced sweating, blisters, calluses, ulcers, signs of infection, bone and joint abnormalities, and other problems. You should have a complete foot exam at least once a year.