Peripheral neuropathy (PN), or nerve damage of the extremities, is one of the most common complications of diabetes (60 percent of all people with the disease develop it at some point). Symptoms include burning, tingling, numbness, a prickly sensation (like “pins and needles”), and muscle weakness. Neuropathy is the result of chronically high blood sugars, so the best way to prevent it is to maintain good glucose control.
To check for neuropathy, your doctor should perform a monofilament test — a measure of the sensation in your feet — at least annually. In this simple yet sensitive evaluation, the monofilament, which is a piece of plastic fiber resembling fishing line, is touched against various parts of the sole of your foot and your ability to feel it at varying pressure is assessed. It is sometimes called the 10-gram monofilament test because the fiber is calibrated to bend to 10 grams of pressure.
People with diabetes can get a free monofilament testing kit from the Lower Extremity Amputation Prevention (LEAP) program.
Avoid the use of hot-water bottles, heating pads, and foot spas if you have neuropathy. You could inadvertently burn yourself, so stick with a warm pair of socks. And never go barefoot inside, even for a late-night trek to the bathroom, as you run the risk of tripping and injuring your exposed foot.
Your doctor may also use a tuning fork on the bottoms of your feet to see if you can sense the vibration. Nerve-conduction studies or velocity tests, which use electrodes to stimulate nerves and then measure the resulting impulses, are a less frequently used, more sophisticated method of diagnosing some neuropathies.
Electromyography (EMG), which uses thin needles inserted into the muscles to measure electrical impulses, may also be performed. These latter two tests can be painful, and will likely not be ordered unless there is some question about the diagnosis.
The monofilament test for peripheral neuropathy