English

Abstract

Diabetes is a major public health problem. 285 million persons worldwide have diabetes, of these 51 million are in India. Diabetic peripheral neuropathy is a major microvascular complication of diabetes. Conventional methods used for the diagnosis of diabetic peripheral neuropathy in clinical practice have limited effectiveness. Since peripheral sensory neuropathy is a pivotal element in the causal pathway to both foot ulceration and amputation, screening and early identification of neuropathy offer a crucial opportunity for the patient with diabetes to actively modulate the course of suboptimal glycaemic control to currently recommended targets, and to implement improved foot care before the onset of significant morbidity. This study was carried out to evaluate the usefulness of simple bed side screening modalities for peripheral neuropathy like vibration perception threshold measurement with biothesiometer, 10g semmes-weinstein monofilament, diabetic neuropathy examination and symptom scores and ankle reflex testing in patients with diabetes mellitus and to seek an optimal screening method in diabetic clinic. INTRODUCTION:Diabetes mellitus comprises a group of common metabolic disorders that share the phenotype of hyperglycaemia. The two broad categories of DM are designated as type 1 and type 2.Type 2 diabetes mellitus is a heterogenous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion and increased glucose production. The number of patients with type 2 diabetes is increasing by epidemic proportions in the world, particularly in India. There is a long presymptomatic phase before the appearance of symptoms of type 2 diabetes. Therefore, Type 2 diabetes is frequently not diagnosed until complications have already occurred. Complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease (CAD), peripheral arterial disease (PAD), cerebrovascular disease). Lower extremity disease, including peripheral neuropathy, foot ulceration, peripheral arterial disease, or lower extremity amputation, is twice as common in diabetic persons compared with non-diabetic persons and it affects 30 per cent of diabetic persons who are older than 40 yr 1 . Diabetic Neuropathy (DN) develops in about 4-10% of diabetic patients after 5 years and in 15% after 20 years 2 . AIMS AND OBJECTIVES: To evaluate the usefulness of the diabetic neuropathy examination score (DNE), diabetic neuropathy symptom (DNS) score, 10-g Semmes-Weinstein monofilament examination, ankle reflex and measuring vibration perception threshold (VPT) with a biothesiometer in the detection of diabetic polyneuropathy in type 2 diabetes patients and to seek an optimal screening method in diabetic clinic in the detection of diabetic polyneuropathy in type 2 diabetes patients.