I will start by saying hello. I am new to this board and like most newbies I have some questions.

I have just found out that I am diabetic. It appears that I may have been diabetic for a while now. My A1C (blood sugar average for 3 months) was 8.9 which means my blood sugar average has been around 240.

I started having "tingles" in my hands and feet a few months ago. They have now progressed to SEVERE electric shocks. It is soooo painful. I also had repair for a ruptured disk last December. I have numbness in my left leg and the dr. said it is from the disk problem. I don't really know if I think that or not. The numbness comes and goes in severity so I wonder if it could be connected with the electric shock feelings. I just to call these pins and needles but I have never felt a needle like that! It is more like lightening strikes. And the itching is awful too. It is not a skin kind of itch like with a rash. It is deep and painful.

My question to all of you is this: How are you tested for peripheral neuropathy? Is it painful like this? Does this sound like anything you experience. I was dx with diabetes by my general doctor but go to see an endocrinologist next week. I also have Lupus.

Make an appointment with a neurologist. The testing that they do usually begins with EMG's and NCV's . . .

Electromyography (EMG) is a technique for evaluating and recording physiologic properties of muscles at rest and while contracting. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells contract, and also when the cells are at rest. (df from Wikipedia)

Nerve Conduction Velocity (NCV) and Electromyography (EMG) are tests your doctor may order to measure nerve conduction and muscle action potential. These tests are performed to determine if symptoms (e.g. sciatica, weakness) are caused by a nerve or muscle disorder. Both tests may be performed. A NCV assesses how well a specific nerve conducts impulses by evaluating the speed of an impulse as it travels along a nerve. This test can help determine if there is nerve damage, the extent of the damage and if nerves have been destroyed. (from Spine Universe)

As a matter of fact, next week I am scheduled for both tests, on both my hands and my feet. I have had the tests previously, about 5 years ago, and recall the discomfort is minor compared to some of the pains, shocks,and burning I get in my extremities.

EMG and nerve conduction studies can only measure damage to larger, myelinated nerves. These include all motor nerves and the sensory nerves that detect mechanical touch, vibration, and friction.

There are much smaller/thinner nerves, however, that have only rudimentary or no myelin coverings at all. These so-called small-fibers subsume the sensations of pain and temperature, much of the autonomic system, and may be damaged without EMG/NCV studies being able to pick up on it--the technology is just not advanced enough at this juncture.

To measure dysfuction of those nerves--and diabetic neuropathy often presents as a small-fiber syndrome--such tests as quantitative sensory testing and sudomotro axon reflex testing are often done, but the current gold standrard is skin biopsy to determine intraepidermal small-fiber density and condition. Take a look at this:

http://www.medscape.com/viewarticle/563262_1

There's also some interesting research being done on using skin biopsies for certain types of demyelinating neuropathies:

http://brain.oxfordjournals.org/cgi/...ull/128/5/1168

Also take a look at this list of serological tests for neuropathy causes:

http://www.questdiagnostics.com/hcp/...eralNeurop.htm

The sad part about all this is that one may have neurological symptoms from both spinal issues and/or more peripheral nerve damage, and these symptoms can be exactly the same and appear in exactly the same bodily regions. EMG/NCV can help localize, or rule out, just where the damage may be occurring along the line, but its ability to do so is much diminished when the small fibers are involved.