Abstract

Context:Many advances have taken place in the detection of diabetic polyneuropathy with respect to examination scores, electrophysiological techniques and quantitative sensory testing.Aim:This study aims to evaluate the discriminative power of the Diabetic Neuropathy Examination Score (DNE), 10-g Semmes-Weinstein Monofilament Examination (SWME) and Quantitative Sensory Testing by Vibration Perception Threshold (VPT) in the diagnosis of diabetic polyneuropathy and seek an optimal screening method in diabetic clinic.Materials and Methods:Hundred consecutive patients with Type 2 diabetes were subjected to Diabetic Neuropathy Symptom Score, DNE score, Semmes-Weinstein monofilament examination, Vibration Perception Threshold and Nerve Conduction Studies; mean ± SD for the various characteristics were calculated. Sensitivity and specificity for the DNE, SWME and VPT were calculated, taking NCS as gold standard.Results:Seventy one of 100 subjects had evidence of neuropathy confirmed by Nerve Conduction Studies, while 29 did not have neuropathy. The DNE score gave a sensitivity of 83% and a specificity of 79%. The sensitivity of SWME was 98.5% and specificity was 55%. Vibration Perception Thresholds yielded a sensitivity of 86% and a specificity of 76%.Conclusions:A simple neurological examination score is as good as Vibration Perception threshold in evaluation of polyneuropathy in a diabetic clinic. It may be a better screening tool for diagnosis of diabetic polyneuropathy in view of the cost effectiveness and ease of applicability.

Highlights

  • Diabetic Polyneuropathy (DPN) is the most common of the heterogeneous group of diabetic neuropathies and contributes to 50 to 70% of nontraumatic amputations.Screening for diabetic polyneuropathy improves foot care and prevents morbidity

  • Seventy one of 100 subjects had evidence of neuropathy confirmed by Nerve Conduction

  • A simple neurological examination score is as good as Vibration Perception threshold in evaluation of polyneuropathy in a diabetic clinic

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Summary

Introduction

Diabetic Polyneuropathy (DPN) is the most common of the heterogeneous group of diabetic neuropathies and contributes to 50 to 70% of nontraumatic amputations. Screening for diabetic polyneuropathy improves foot care and prevents morbidity. Current level of evidence for optimal screening method is limited. Many advances have taken place in the detection of DPN with respect to examination scores, electrophysiological techniques and quantitative sensory testing. A consensus indicates the need for abnormalities in at least two of five possible modalities to make the diagnosis for research purposes.[1] This study aims to evaluate the discriminative power of the Diabetic Neuropathy

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