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Sudoscan measures electrochemical skin conductance (ESC) of hands and feet through reverse iontophoresis. Sudoscan is a promising, sensitive tool to detect neuropathy in patients with DM (diabetic melitus). Changes in peripheral autonomic nervous system function are an early manifestation of distal small fiber neuropathy. Sudomotor dysfunction is one of the earliest detectable neurophysiologic abnormalities in distal small fiber neuropathies