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DN was evaluated by traditional Michigan Neuropathy Screening Instrument (MNSI), evaluation of painful neuropathy (ID\u2010Pain, DN4) and sudomotor function by measuring electrochemical skin conductance (ESC). Of the 120 T2DM patients and 20 healthy adults enrolled, T2DM patients are categorized into normal sudomotor (ESC\u2009&gt;60\u2009\u03bcS) and sudomotor dysfunction (ESC\u2009\u2264\u200960\u2009\u03bcS) groups. Spectral difference analyses reveal significant intergroup differences, whereas traditional examinations cannot distinguish between the two groups. HSI waveform reflectance gradually increases with disease severity, at 1400 to 1600\u2009nm. The area under the curve (AUC) of receiver operating characteristic (ROC) analysis for abnormal ESC is \u22650.8 for all four HSI methods. 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