Peripheral neuropathy profile in various groups of diabetics

The results of applying a battery of peripheral nerve function tests in three groups of diabetics are reported. The tests examined the integrity of all the major subgroups of nerve fibres. The diabetics were grouped according to the clinical severity of their neuropathy: Group I--11 patients with long standing diabetes but clinically insignificant neuropathy, Group II--27 patients with mild neuropathy and Group III--23 patients with neuropathic foot lesions. As expected the incidence of abnormality of all functions increased from Group I to III, but within a group there was no clear pattern of differential involvement of different fibre types. The study has identified those tests that are suitable for detecting early neuropathy (warming and vibration perception thresholds and sensory nerve action potentials) and those which are likely to be useful in assessing deterioration or improvement (particularly vibration perception threshold), but since the different tests cannot be equally matched for sensitivity it is not possible to interpret the results in terms of the degree of pathological involvement of different fibre groups.