The last three require urgent attention. Special training may be required for fundoscopy. Neuropathy Neuropathy is common in diabetes and causes considerable morbidity. Most commonly distal sensory nerves are affected but motor nerves and the autonomic system are also affected. Diabetic neuropathy can be prevented by good glycaemic control.
Advanced neuropathy is irreversible so that early detection is important.
N.B. Symptomatic therapy is available for many of the neuropathies. Much of this is preventable through proper care and education. N.B. Therapeutic interventions differ for primarily neuropathic vs primarily ischaemic feet. Clinical nephropathy is marked by gross proteinuria, as measured with a standard urine dipstick, with or without a raised serum creatinine level. Such subjects require referral to a speciatist.