Assessment of Peripheral Diabetic Neuropathy: New versus Conventional Methods

Abstract

Diabetic peripheral sensory neuropathy is a common complication of diabetes that can cause considerable morbidity and mortality in diabetic patients. It increases the risk for complications of diabetes such as amputations and foot ulcers, thus it is important to detect peripheral neuropathy early so that diabetic foot care education can be provided and protective measures can be used to avoid devastating complications with the diabetic foot. Our aim of this paper was to study the incidence and extent of peripheral sensory neuropathy in diabetic patients with <5, 5-10 and >10 years duration of diabetes using two different modalities of testing: 5.07 Semmes-Weinstein Monofilament Testing (SWMT) and Rapid- Current Perception Threshold (R-CPT) measurements using the Neurometer. Our study population consisted of 60 patients treated for diabetes mellitus in the Unirea Medical Center. Thirty-five, 15 and 5 patients had duration of diabetes of 5, 5-10 and 10 years, respectively. All patients were tested for sensory neuropathy using SWMT and the Neurometer.Our results showed that a higher incidence of sensory neuropathy was found in patients with a longer duration of diabetes, especially in those who have been diagnosed for >10 years. Even for patients with <5 years duration of diabetes, the incidence of sensory neuropathy detected was considerable. The incidence of neuropathy detected continued to increase with length of duration of diabetes. Hence, we recommend screening of patients for neuropathy as soon as they are diagnosed with diabetes. Also CPT measurement with the Neurometer has been shown to be clinically valuable in detecting peripheral nerve dysfunction. Applying 5Hz current detected the most patients with diabetic neuropathy compared to the other two frequencies, finding that confirm the well-known fact that diabetes mellitus is a small fiber disease.KeywordsdiabetesneuropathyNeurometer