Újszeged Medical Center

We are paying increasing attention to the recognition and treatment of diabetes complications, as these significantly impact life expectancy. One reason for this is that, unfortunately, even today, diabetes often comes to light only after complications have developed, despite the metabolic disorder potentially existing for decades. Another reason is that, thanks to advanced medication and insulin treatments aimed at reducing blood sugar levels, diabetes is now well-managed. Many patients have been treated for decades, giving them a chance to develop late-stage complications.

We are also focusing more on nerve damage and its screening because recent scientific findings show that patients who develop even asymptomatic neuropathy are at increased risk for other cardiovascular complications. These findings are supported by the internationally recognized scientific work of the clinical diabetologists at the Újszeged Diabetes Center. Their research is published not only in scientific articles and at conferences but also in books. With this advanced knowledge, patients flagged during neuropathy screenings can undergo further evaluations, such as cardiovascular reflex tests for additional risk assessment, and can receive specialized cardiological, neurological, or nephrological care to prevent fatal outcomes.

According to the current state of science, maintaining a near-normal blood glucose level (a normoglycemic state) can prevent or at least delay microangiopathic (small blood vessel) complications and slow their progression. This means that even the progression of diabetes complications identified in later stages can be slowed with proper metabolic control and targeted treatment. Preventing macroangiopathic (large blood vessel) complications, however, requires a comprehensive approach to addressing the underlying causes.

Diabetic nerve damage (neuropathy) accounts for one-third of all neuropathies and is a common condition that can first draw attention to diabetes. Typical symptoms of nerve damage include reduced or lost sensations of heat, pain, vibration, or touch. As a result, patients may not notice wounds or ulcers forming on their feet. Common symptoms include unstable walking, numbness, or tingling in the feet. These symptoms are generally irreversible, making it critical to detect diabetes and neuropathy as early as possible. A simple, painless diagnostic option is the Neurometer test, which can be completed in about 30 minutes at the Újszeged Diabetes Center with prior appointment scheduling. If abnormalities are detected, both diabetologists and neurologists may recommend discounted medications to alleviate symptoms.

The Neurometer is a diagnostic device capable of simultaneously and specifically measuring all three types of sensory nerve fibers, providing quantitative results. The test is based on determining the current perception threshold during electrical stimulation through the skin. The current strength is gradually increased until the patient perceives the impulse and then decreased until it is no longer felt. Testing is conducted on both the upper and lower extremities at three frequencies (2 kHz, 250 Hz, 5 Hz). High-frequency data provide information about pressure and vibration sensitivity thresholds, reflecting thick fiber function. Low-frequency data correlate with heat sensation tests and provide insights into thin fiber function. Results above the normal range indicate delayed sensation and reduced nerve fiber function, while values below the normal range suggest hypersensitivity. The Neurometer thus provides quantitative assessments of thin, unmyelinated, pain-sensing nerve fibers.

The Neurometer test is recommended annually for people with diabetes but should be performed without delay if the following symptoms are experienced:

• Numbness or tingling in the feet, especially if "sock-like."
• Cold or frosty extremities.
• Burning or pinprick sensations.
• Slow-healing wounds on the feet.
• Unsteady gait.

In preventing neuropathy, the Újszeged Diabetes Center prioritizes nerve damage screening. This emphasis is supported by recent scientific findings indicating that patients with even asymptomatic neuropathy are at higher risk for cardiovascular complications. These results are reinforced by the internationally recognized work of the Diabetes Center’s clinical diabetologists, whose findings are disseminated in scientific publications, conferences, and books. With this knowledge, patients identified during neuropathy screenings can access specialized care earlier—whether cardiological, neurological, or nephrological—thereby avoiding fatal complications.

Treating complications often requires the collaboration of multiple medical specialties. At the Újszeged Diabetes Center, this interdisciplinary care is unique, supported by outstanding specialists excelling in both scientific research and clinical practice. At the Diabetes Center, the annually recommended comprehensive complication screening tests can be completed within a few hours after prior appointment scheduling.

COMPREHENSIVE COMPLICATION SCREENING PACKAGE

• Laboratory Tests – Risk Screening (lipid profile, uric acid, HgbA1c, body fat, BMI, blood pressure).
• Urinalysis – Proteinuria Screening.
• Neurometer – Screening for Nerve Damage.
• ECG – Coronary Artery Screening.
• Doppler Ultrasound – Examination for Peripheral Artery Narrowing.