Reliability of diabetic neuropathy symptom and diabetic neuropathy examination scoring system for the diagnosis of diabetic peripheral neuropathy in type 2 diabetes mellitus patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20195931Keywords:
Bio esthesiometer, Diabetic neuropathy symptom score, Diabetic neuropathy examination score, Nerve conduction studies, Semmes-Weinstein monofilament examinationAbstract
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.
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References
Dyck PJ. In: Severity and staging of diabetic polyneuropathy in Textbook of Diabetic Neuropathy. Gries FA, Cameron NE, Low PA, Ziegler D, editors. Stutt gart: Thieme; 2003:170-5.
Meijer JW, Smit AJ, van Sonderen E, Groothoff JW, Eisma WH, Links TP. Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the diabetic neuropathy symptom score. Diabetes Med. 2002;19:962-5.
Ashok S, Ramu M, Deepa R, Mohan V. Prevalence of neuropathy in type 2 diabetic patients attending a diabetes centre in South India. JAPI. 2002 Apr 1;50:546-50.
Dyck PJ. Detection, characterization, and staging of polyneuropathy: Assessed in diabetics. Muscle Nerve. 1988;11:21-32.
Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001;24:250-6.
Boulton AJ, Kubrusly DB, Bowker JH, Skyler JS, Sosenko JM. Impaired vibratory perception and diabetic foot ulceration. Diabetes Med. 1986;3:335
Meijer JW, Bosma E, Lefrandt JD, Links TP, Smit AJ, Stewart RE, et al. Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores. Diab Care. 2003;26:697-701.
Meijer JWG, van Sonderen E, Blaauwwiekel EE, Smit AJ, Groothoff JW, Eisma WH, et al. Diabetic neuropathy examination: A hierarchical scoring system to diagnose distal polyneuropathy in diabetes. Diab Care. 2000;23:750-3.
Kumar S, Fernando DJ, Veves A, Knowles EA, Young MJ, Boulton AJ. Semmes-Weinstein monofilaments: A simple effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration. Diab Res Clin Pract. 1991;13:63-8.
Armstrong DG, Lavery LA, Vela SA, Quebedeaux TC, Fleischli JG. Choosing a practical screening instrument to identify patients at risk of diabetic foot ulceration. Arch Intern Med. 1998;153:289-92.
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