Are the symptoms of diabetic peripheral neuropathy in Nigerian patients objective? An evaluation using the United Kingdom Screening Test (UKST) and Bio-Thesiometry.

Abstract

Symptoms suggestive of peripheral neuropathy (PN) in diabetes mellitus (DM) do not always indicate presence ofunderlying PN. A pioneering study among Nigerian diabetic subjects to evaluate the objectivity of their symptoms of PN using two objective diagnostic instruments for PN the United Kingdom Screening Test (UKST) and Bio-Thesiometry. One hundred and twenty diabetic participants and a similar number of non-diabetic controls were screened for symptoms of PN using the UKST symptoms score and subsequently separated into two groups those with symptoms ofPN and those without. The "symptomatic" cases and controls were further evaluated with the UKST signs score and Bio-Thesiometry to assess the objectivity of the symptoms. Among 120 diabetic participants, 83(69.2%) had neuropathic symptoms (the symptomatic cases) while 10 (8.3%) of the 120 non-diabetic controls had neuropathic symptoms (the symptomatic controls). Among the cases, UKST signs score detected PN in 89.2% (74/83) and Bio-Thesiometry 71.1% (59/83), the difference in the ability of the two methods to detect PN in this group being statistically significant (X2 = 8.51, df = 1, p < 0.01). Among the controls, UKST detected PN in 100.0% (10/10) compared to Bio-thesiometry (50.0%; 5/10), the difference in the ability of the two methods to detect PN in this group also being statistically significant (X2 = 4.27, df = 1, p < 0.05, using continuity correction factor). The difference in the ability of both methods to detect PN between the cases and controls was however not statistically significant (X2 = 0.68, df = 1, p > 0.3) The symptoms of PN among Nigerian diabetic subjects when evaluated with a gold standard for scoring the symptoms (the UKST symptoms score) are real, objective and truly indicate presence of underlying PN. Diabetic subjects presenting to medical clinics with symptoms of PN should receive serious attention and evaluation using this gold standard to detect early those with genuine PN and are at risk of foot ulceration from PN.