Nerve conduction tests may show reduced functioning of the peripheral nerves, but seldom correlate with the severity of diabetic peripheral neuropathy and are not appropriate as routine tests for the condition. Small fiber neuropathy measured by QST and Sudomotor function tests, through electrochemical skin conductance, is more and more indicated to assess early signs of diabetic neuropathy and autonomic neuropathy. Classification
Diabetic neuropathy encompasses a series of different neuropathic syndromes which can be categorized as follows:
Focal and multifocal neuropathies:
Mononeuropathy which affects one nerve
Amyotrophy or radiculopathy such as proximal diabetic neuropathy, affecting a specific pattern of nerves
Multiple lesions, affecting nerves that dont follow a specific pattern, also called "mononeuritis multiplex"
Nerve damage from entrapment (e.g. median, ulnar, peroneal)
Symmetrical neuropathies:
Sensory
Autonomic
Distal symmetrical polyneuropathy (DSPN), the diabetic type of which is also known as diabetic peripheral neuropathy (DPN) (most common presentation)

Prevention
Diabetic neuropathy can be largely prevented by maintaining blood glucose levels and lifestyle modifications. Enhanced glucose control methods include more frequent subcutaneous insulin administration, continuous insulin infusion, oral antidiabetic agents, while lifestyle modifications may include exercise alone, or in combination with dietary modifications. Enhanced glucose control prevents the development of clinical neuropathy and reduces nerve abnormalities in type 1 diabetes, and delays the onset of neuropathy in both types of diabetes. However, such methods may increase the likelihood of experiencing a hypoglycemic event, and many of these more aggressive methods require more frequent insulin use which has been associated with excessive risk of falls. Treatment
Blood glucose management
Treatment of early manifestations of sensorimotor polyneuropathy involves improving glycemic control.
Nifurtimox, sold under the brand name Lampit, is a medication used to treat Chagas disease and sleeping sickness. For sleeping sickness it is used together with eflornithine in nifurtimox-eflornithine combination treatment. In Chagas disease it is a second-line option to benznidazole. It is given by mouth.Common side effects include abdominal pain, headache, nausea, and weight loss. There are concerns from animal studies that it may increase the risk of cancer but these concerns have not been found in human trials. Nifurtimox is not recommended in pregnancy or in those with significant kidney or liver problems. It is a type of nitrofuran.Nifurtimox came into medication use in 1965. It is on the World Health Organizations List of Essential Medicines. It is not available commercially in Canada. It was approved for medical use in the United States in August 2020. In regions of the world where the disease is common nifurtimox is provided for free by the World Health Organization (WHO). Medical uses
Nifurtimox has been used to treat Chagas disease, when it is given for 30 to 60 days. However, long-term use of nifurtimox does increase chances of adverse events like gastrointestinal and neurological side effects.