DN is defined as the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes. A careful clinical examination is needed for the diagnosis, since asymptomatic neuropathy is common (12) 4905 /id}. A minimum of two abnormalities (symptoms, signs, nerve conduction abnormalities, quantitative sensory tests or quantitative autonomic tests) is required for diagnosis and, for clinical studies, one of theses two abnormalities should include quantitative tests or electrophysiology (12,13). Standardized testing using nerve symptom scores and nerve impairment scores to quantify weakness, loss of reflexes and sensory deficits has proved invaluable in diagnosis and monitoring of progress and is indispensable for clinical trials.