Abstract
BackgroundDiabetic Peripheral Neuropathy is one of the most prevalent complications of diabetes mellitus. The development and progression of such complications are responsible for much of the morbidity and mortality. The purpose of this study was to evaluate the effectiveness of Semmes–Weinstein monofilament ten gram in 3, 4, eight and ten points in the screening of diabetic peripheral neuropathy in patients with diabetes mellitus.MethodsIn a descriptive correlational design, 150 patients with diabetes mellitus were selected using convenience sampling. All patients were evaluated for sensory neuropathy using ten gram Semmes-Weinstein Monofilaments and questionnaire on neuropathy symptoms. In the next phase, nerve conduction velocity was examined. The most common subjective symptoms were paresthesia of both feet, pain in feet, burning sensation in the extremities and numbness in the extremities.ResultsThe results showed that the sensitivity of Monofilament in three and four points were 35.9 to 53.8 present and 38.5 to 51.3 percent respectively. Specificity of Monofilament the same points, were 73.9 to 84.7 and 73 to 87.4 percent respectively. Monofilament sensitivity at eight and ten points were 38.5 to 61.5 and 64.1 to 30.8 percent respectively. Also, specificity of the same points were 77.5 to 95.5 and 64 to 89.2 percent respectively. It was revealed that the difference sensitivity and specificity of Monofilament in three and four points with sensitivity and specificity in eight and ten point is not statistically significant.ConclusionsThis study showed that Semmes-Weinstein monofilament can easily use as a simple and inexpensive device for screening. Since increasing the number of points it was not significantly difference. Therefore, we suggest that screening for diabetic peripheral neuropathy, especially in large populations to avoid wasting time on Monofilament application, areas like three or four points eight and ten points could be used.
Highlights
Diabetes is the most common metabolic disease worldwide
10.15 billion dollars are annually spent for the treatment of diabetic neuropathy and its complications in the U.S early prevention from the complications of diabetic neuropathy is essential for the recovery of these patients [10]
Since in the most studies, a 10 g monofilament has been used often for screening, and no study still has been conducted for comparing 10 g monofilament in different points carefully, this study was designed with the following objectives: The first aim of our study was to answer the question that whether increasing the number of points to use in screening monofilament neuropathy can be accompanied with high sensitivity? The second objective was to compare the sensitivity and specificity of monofilament with the Modified neuropathy disability score
Summary
IDF and WHO reported increasing incidence all around the world especially in developing countries [1]. Prevalence of diabetes mellitus (DM) in different parts of Iran is between 7.5–7.9 percent. Diabetic neuropathy is one of the most common complications of DM. These complications, especially ulcer and amputation, affect the quality of patients’ life, which in turn leads to repeated hospitalizations and increased health care costs [9]. Diabetic Peripheral Neuropathy is one of the most prevalent complications of diabetes mellitus. The purpose of this study was to evaluate the effectiveness of Semmes–Weinstein monofilament ten gram in 3, 4, eight and ten points in the screening of diabetic peripheral neuropathy in patients with diabetes mellitus
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