糖尿病周邊神經病變(diabetic peripheral neuropathy) 是最常見的糖尿病長期併發症，然而常被忽視而沒能及早診斷。其實糖尿病周邊神經病變，在疾病早期，就已可能發生，若未及早發現、及早治療，之後往往造成病患身體不適、增高醫療費用、與降低生活品質，其重要性不容小覷。現今已有多項評估神經功能的方法，可以輔佐我們早期診斷糖尿病周邊神經病變，其中催汗試驗(sudomotor testing) 即前景看好。人體汗腺的分泌功能，是由神經節後無髓鞘的C 型神經纖維所支配。催汗試驗利用測試人體皮膚汗腺導電度，來評估交感神經系統功能；同時，由於C 型神經纖維屬性接近周邊神經系統中的小神經纖維，亦可用於評估冷熱覺、痛覺、本體感覺等小神經纖維功能。本文回顧相關文獻，整理目前此新穎工具的臨床研究結果，並介紹催汗儀(Sudoscan) 使用上的優缺點，及應用催汗儀來診斷糖尿病神經病變的流程。

Diabetic peripheral neuropathy (DPN) is one of the most common long-term diabetic complications. It occurs at the early stage of diabetes and contributes significantly to the increased risk of foot ulcer and amputation in patients with diabetes. DPN could lead to high hospital admission rates, high medical expenditure, and low quality of life for the patients. Testing methods like monofilament and clinical examination detect only advanced disease. Nowadays, many specialized tests are available for the management of DPN. Among them, Sudoscan is a promising tool for the diagnosis of DPN. Sweat glands are innervated by unmyelinated postganglionic sympathetic C fibers. Sudoscan is based on electrochemical conductance measurement from the reaction between sodium chloride of sweat and nickel of the electrodes placed on patient’s palms and feet. Because C fibers are physiologically close to the small fibers of peripheral nerve system, Sudoscan could also be used to assess small fiber disease. Herein, we review the literatures and discuss the advantages and disadvantages of using Sudoscan to diagnose DPN. We also introduce a newly proposed diagnostic algorithm for the clinical application of Sudoscan.