Reliability of diabetic neuropathy symptom and diabetic neuropathy examination scoring system for the diagnosis of diabetic peripheral neuropathy in type 2 diabetes mellitus patients

Labani M. Ghosh, Jyoti G. Mannari


Background: This study aims to evaluate the reliability of the Diabetic Neuropathy Examination Score (DNE), 10-g Semmes-Weinstein Monofilament Examination and Quantitative Sensory Testing by Vibration Perception Threshold (VPT) in the diagnosis of diabetic polyneuropathy and seek a cost effective and reliable screening method in diabetic OPD and IPD against the gold standard of NCV.

Methods: This study was carried out in 50 confirmed type 2 diabetic patients matched for age, sex, duration and ABI >0.9 irrespective of the presenting complaints. Patients with either limb amputation, other reasons for peripheral neuropathy, ABI <0.9, critical and comatose were excluded. A complete neurological assessment using a symptom questionnaire, Semmes Weinstein monofilament, vibration and thermal threshold perception analyzer was done and recorded. A score was given out of 20. The patients were retrograde subjected to NCV by a blinded technician and the readings were then compared to the scores.

Results: The level of significance between the total neuropathy score and the presence of neuropathy (by NCV) was very significant (p<0.0001) with an association of 0.932. In patients with a mean total neuropathy score of 3.28,10.80 and 15.37, there was no, mild and severe levels of neuropathy in NCV respectively.

Conclusions: There is correlation between the total neurological scores and NCV. Therefore, it can be used to screen all diabetic patients for earliest signs of diabetic neuropathy with sustainable results.


Bio esthesiometer, Diabetic neuropathy symptom score, Diabetic neuropathy examination score, Nerve conduction studies, Semmes-Weinstein monofilament examination

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