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Risk Factors include: Long-term poor blood sugar control (primary risk factor) Cardiovascular disease Age Male gender Elevated triglycerides High body mass index Smoking and excess alcohol consumption Diagnosis and Treatment Diagnosis Presence of characteristic symptoms including lower extremity numbness, pain, sensitivity, dryness, muscle weakness/wasting, difficulty walking, and loss of temperature sensation Physical exam Fasting blood glucose, hemoglobin A1C, CBC/Chemistry panel, others Nerve conduction studies or electromyograms on the foot Treatment Judicious tight blood sugar control is paramount in controlling progression of diabetic neuropathy