Early Detection of Diabetic Peripheral Neuropathy: A Focus on Small Nerve Fibres

摘要: Diabetic peripheral neuropathy (DPN) is the most common complication of both type 1 and 2 diabetes. As a result, neuropathic pain, diabetic foot ulcers lower-limb amputations impact drastically on quality life, contributing to individual, societal, financial healthcare burden DPN diagnosed at late, often pre-ulcerative stage due lack early systematic screening endorsement monofilament testing which identifies advanced only. Compared success eye kidney programmes there clearly an unmet need for objective reliable biomarker detection DPN. This article critically appraises research clinical methods diagnosis or In brief, functional measures are subjective difficult implement technical complexity. Moreover, skin biopsy invasive, expensive lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests convenient easy however questions raised regarding their suitability use in small fibre evaluation. Corneal confocal microscopy (CCM) rapid, non-invasive, reproducible technique quantify damage repair can be conducted alongside retinopathy screening. CCM sub-clinical DPN, predicts development allows staging severity. Automated quantification with AI has enabled enhanced unbiased fibres potentially Improved tools will prevent reduce ulceration primary aim reducing prevalence this microvascular complication.