Report and recommendations of the san antonio conference on diabetic neuropathy

O n 8-10 February 1988, a conference on peripheral neuropathy in diabetes was held in San Antonio, Texas, to review the progress achieved in this field over the past few years. A strong impetus for convening this conference was the recent burst of clinical investigations and trials in diabetic neuropathy and a perception that recent research gains were not widely recognized. The purpose of the conference was to assess the state of knowledge of diabetic neuropathy and to recommend a set of research guidelines for future clinical investigations. In this report, investigation was defined as epidemiological surveys, studies of natural history, and clinical trials of proposed therapies for treatment or prevention of diabetic neuropathy. The conference was sponsored by the American Diabetes Association and the American Academy of Neurology. The conference format consisted of a panel of 10 experts in the fields of diabetes and peripheral neuropathy who heard 1.5 days of presentations by 23 participants chosen for their expertise in particular aspects of diabetic neuropathy. The participants' presentations were divided into six areas: clinical measures, morphological and biochemical assessment, electrodiagnosis, epidemiology, autonomic nervous system testing, and sensory testing. The panel prepared this report on the conference. The following operational definition of diabetic peripheral neuropathy was adopted by the conferees: