Evaluating The Objectivity Of The Symptoms Of “Symptomatic” Diabetic Peripheral Neuropathy Using Two Methods

Abstract

Background: Presence of symptoms of peripheral neuropathy (PN) in diabetes mellitus (DM) does not invariably indicate presence of underlying PN. Objective: To evaluate the objectivity of the symptoms of PN among DM subjects using two objective diagnostic instruments for PN – the United Kingdom Screening Test (UKST) and Aesthesiometry. Subjects and methods: 120 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 of PN and those without. The “symptomatic” cases and controls were further evaluated with the UKST signs score and Aesthesiometry to assess the objectivity of the symptoms. Results: 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 Aesthesiometry 77.1% (64/83), while among the controls, both methods detected PN in all the participants (100.0%; 10/10). The difference in the ability of both methods to detect PN between the cases and controls was not statistically significant (2 = 0.08, df = 1, p > 0.9) Conclusion: The symptoms of PN among Nigerian diabetic subjects when evaluated with the UKST symptoms score are objective and truly indicate presence of underlying PN. Diabetic subjects with symptoms of PN should be evaluated using this standard to detect early those with genuine PN and are at risk of foot ulceration from PN. Keywords: Diabetic Mellitus, Peripheral Neuropathy, United Kingdom Screening Test, Aesthesiometry. Tropical Journal of Medical Research Vol. 11 (2) 2007: pp. 1-8