Small nerve fibers are the very first targets of diabetes. For a substantial number of patients, irreversible tissue damage (peripheral vascular disease, nephropathy, retinopathy, neuropathy) have already set in at the time of diagnosis . 60-70% of patients with diabetes have neuropathies .
Early identification of these complications, which may be asymptomatic in up to 50% of diabetic patients, has the potential to reduce or delay their complications with timely preventative treatment.
The American Diabetes Association (ADA) mandates that all patients with diabetes be screened annually for peripheral and autonomic neuropathy.