Screening techniques to identify occurrence of peripheral neuropathy among diabetic patients

Elsaida Bagdady

doi:10.21608/pssjn.2015.34159

Abstract

Background Neuropathy is the greatest source of morbidity associated with diabetes, affecting up to 50% of those with long-standing disease, and pain as a symptom of neuropathy may be seen in as many as one third of all patients with diabetes. Aim: - The aim of this study was screen the occurrence of peripheral neuropathy among diabetic patients. Subjects and methods The design used for conduction of this study was prospective (cohort) study). Subjects: - A total 300 adults diabetic patients. Tools of data collection:-Tool I Diabetic patient knowledge scaduale, Tool II Diabetic foot examination checklist. It contained two items. General examination Highet , weight , BMI , heart rate , blood pressure, specific foot examination, diagnosis of diabetic peripheral neuropathy using neuropathy symptoms score (NSS),neuropathy disability score (NDS),Pressure perception using 10gm Semmes Winston monofilament on10 sites in two feet and sensory assessment Results: -. The patients who had ≥ 3in total score of neuropathy symptoms score (NSS) were 23%, (10.3%) had total score ≥6 in neuropathy disability score. Loss of protective sensation was common in (11.0%) of patients. The total patients diagnosed with neuropathy (Abnormal with one of these three parameters) were 27 .3 % of studied sample. Also the study reveals that assessment of foot pressure perception using 10gm monofilament had the best sensitivity.Conclusion based on the findings it was concluded that diabetic peripheral neuropathy was diagnosed in one third of studied sample ,10gm monofilament had the best sensitivity Recommendations .All patients with diabetes should be screened at least annually for presence of diabetic peripheral neuropathy. Foot care education must be provided to every diabetic patient with regular confirmation

Highlights

Conclusion based on the findings it was concluded that diabetic peripheral neuropathy was diagnosed in one third of studied sample,10gm monofilament had the best sensitivity Recommendations .All patients with diabetes should be screened at least annually for presence of diabetic peripheral neuropathy
Foot care education must be provided to every diabetic patient with regular confirmation
Regarding neuropathy symptoms score (NSS) the present study revealed that numbness followed by tingling and sharp shooting pain were the most common symptoms related to peripheral neuropathy,the same result was found in the study conducted by (Alston,2008 ) In addition (Boulton,2012) agreed that neuropathy cannot be diagnosed without a careful clinical examination; absence of symptoms must never be equated with absence of neuropathy, as asymptomatic neuropathy is common and there are many divisions of the diabetic neuropathies

Summary

Introduction

Neuropathic pain is difficult to manage, and the available treatment options rarely provide total relief. Lack of definitive treatment success is related to the multifocal and poorly understood pathogenesis of painful diabetic neuropathy (PDN). An understanding of PDN assessment and management strategies is essential for diabetes educators. Neuropathy is the greatest source of morbidity associated with diabetes, affecting up to 50% of those with long-standing disease, and pain as a symptom of neuropathy may be seen in as many as one third of all patients with diabetes

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Conclusion