Brain (2004), 127, E20Letters to the Editor Skin denervation in type 2 diabetes: correlations with diabetic duration and functional impairments—a comment

We read with great interest the article by Shun et al. (2004) recently published in your journal. The authors report on a significant skin denervation and its correlations with diabetes duration and functional impairments. On nerve conduction studies, they observed abnormal findings in only 50 % of diabetic patients. It is well known that conventional nerve conduction tests fail to detect function of the most distal part of sensory nerve fibres or receptors. Recently we reported on a neurophysiological pattern providing data on the most extreme segments of peripheral sensory nerves (Aprile et al., 2003). During conventional orthodromic sensory conduction studies using submaximal stimulus intensity, a sensory response characterized by a mor-phology with two peaks (double peak potential) is observed; the second peak disappears with increasing stimulatio