Accuracy of Monofilament in the Assessment of Diabetic Neuropathy

Abstract

Background: Diabetes Mellitus is one of the leading contributors of global burden of chronic diseases. Detection of diabetic end-organ damage, particularly during its early stages, is very crucial and significant. Peripheral neuropathy is a known vascular complication of chronic diabetes. Several modalities of detecting peripheral neuropathy clinically are available. The purpose of this study was to evaluate Semmes-Weinsten monofilament10gm in screening the diabetic peripheral neuropathy.
 Aims and Objectives: To assess the accuracy of monofilament test in assessment of Diabetic neuropathy.
 Materials and Methods: We analysed the data collected from 50 patients admitted in the medical wards or attending medical outxpatient department, diagnosed to have Diabetes, from august 2018 to august 2019. The results of three clinical tests, monofilament test, vibration (test) and ankle jerk (test), were performed. In the next phase nerve conduction velocity was examined in those with peripheral neuropathy. The results then compared with each other and with the gold standard nerve conduction velocity study.
 Results: Data were pooled and coded in Microsoft Excel spreadsheet. R Version 3.4.1 and SPSS V.22 software was used to analyze the data. The sensitivity and specificity of monofilament test as in comparison with other clinical tests as well as the gold standard nerve conduction test was found to be 58% and 88% respectively. The sensitivity of achilles reflex was 30% and specificity being 80% in comparison with the nerve conduction velocity test. The sensitivity and specificity of vibration sense was 38% and 58% respectively. Hence the Simmes-Weinstein monofilament test was found to be more accurate test for clinical diagnosis of peripheral neuropathy in patients with diabetes.
 Limitations: Study population was small.
 Conclusion: This study showed that Semmes-Weinstein monofilament can be easily used as a simple and inexpensive device for screening for peripheral neuropathy.