Clinical diagnosis of distal diabetic polyneuropathy using neurological examination scores: correlation with nerve conduction studies

Kamel, Shereen R.; Hamdy, Mahmoud; Omar, Hanaa A.S. Abo; Kamal, Amal; Ali, Lamia H; El-Karim, Ahmed H. Abd

doi:10.4103/1110-161x.163945

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Moreover, there were significant positive correlations between both diabetes duration and HbA1c level with clinical severity, assessed by TCNS, and electrophysiologic severity of DSPN (P<0.000) These detected correlation adds more importance on the duration of diabetic illness and the glycemic control over years for the development of DSPN. Similar results were reported by Kamel et al [25] and Kovac et al [26].…”

Section: Resultssupporting

confidence: 92%

Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus

Elhameed

Elsawy

Mgalaa

et al. 2019

Egypt Rheumatol Rehabil

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Objective To evaluate the role of soluble Fas (sFas) and soluble Fas ligand (sFasL) in the pathogenesis of distal symmetrical polyneuropathy (DSPN) in patients with type 2 diabetes mellitus, and to analyze the relationship between these apoptotic markers with clinical parameters and electrophysiologic profile of DSPN, as well as with different diabetic factors among those patients. Patients and methods The study included 60 Egyptians with type 2 diabetes mellitus. All patients were evaluated clinically for DSPN by using Michigan Neuropathy Screening Instrument. Electrophysiological diagnosis of DSPN was based on the criteria suggested by the European Standardized Telematic tool to Evaluate Electrodiagnostic Methods group. Diabetic patients were divided into two groups according to the electrophysiological findings: group A included patients with DSPN (N=42), and group B included patients without DSPN (N=18). The severity of DSPN among group A patients was assessed clinically using Toronto Clinical Neuropathy Score and electrophysiologically by the severity score proposed by Hidasi and colleagues. The study also included 30 healthy volunteers as a control group. Serum levels of sFas and sFasL were assessed in all the studied groups. Results Serum level of sFas was significantly elevated in diabetic patients with DSPN compared with diabetics without DSPN and nondiabetic control (P=0.029 and 0.000). Receiver operating characteristic (ROC) curve analysis detected that sFas was statistically significant in discriminating between diabetic patients with DSPN from those patients without DSPN with an accuracy of 66%. The cutoff point that has the highest sensitivity (61%) and specificity (62%) was 33.3 ng/ml. Serum level of sFas showed a positive significant correlation with the electrophysiological severity of DSPN (P=0.020). Serum level of sFasL did not show statistically significant difference between all the studied groups. Conclusion Fas-mediated apoptosis has an important role in the development of diabetic DSPN and is correlated with its electrophysiological severity.

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Section: Resultssupporting

confidence: 92%

Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus

Elhameed

Elsawy

Mgalaa

et al. 2019

Egypt Rheumatol Rehabil

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show abstract

“…A cross-sectional study in T2DM patients that examined the nerve conduction velocities of motor and sensory nerves, using NSS and NDS in patients with clinically detectable neuropathy showed significant electrophysiological changes with the duration of T2DM 475 . Similar results were observed in another study where NSS and NDS helped in prompt evaluation of diabetic sensorimotor polyneuropathy and in diagnosing subclinical cases [476][477][478] . A study that validated the use of NSS and NDS for clinical diagnosis of peripheral neuropathy in middle aged 855 T2DM patients showed that NSS and NDS can detect diabetic neuropathy with a sensitivity of 71.1% and specificity of 90% and was found to be simple, acceptable, reproducible and validated method for early diagnosis of diabetic neuropathy 479,480 .…”

Section: Rationale and Evidencesupporting

confidence: 87%

RSSDI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2022

2022

Int J Diabetes Dev Ctries

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“…[ 411 ] Similar results were observed in another study where NSS and NDS together helped in prompt evaluation of diabetic sensorimotor polyneuropathy and also in diagnosing subclinical cases. [ 412 413 414 ] A study that validated the use of NSS and NDS for clinical diagnosis of peripheral neuropathy in middle aged 855 T2DM patients showed that NSS and NDS can detect diabetic neuropathy with a sensitivity of 71.1% and specificity of 90% and was found to be simple, acceptable, reproducible and validated method for early diagnosis of diabetic neuropathy. [ 294 410 ] The panel emphasized on neurological examination using NSS and NDS as it is important bed side tool and a useful resource in evaluating diabetic sensorimotor polyneuropathy.…”

Section: R Ationale and E Videncementioning

confidence: 99%

“…However, use of simple clinical scores such as NSS and diabetic neuropathy examination (DNE) scores were found to be simple and useful tools for the diagnosis of peripheral neuropathy in-patients with diabetes. [ 502 503 ] Moreover, a good correlation between VPT score with tuning fork, monofilament and ankle reflex was found suggesting that simple bed side tests are useful in clinical practice, even in those subjects in whom foot care practices are not followed. [ 504 505 ] Using NSS and NDS in T2DM patients has been found to be a useful resource in evaluating diabetic sensorimotor polyneuropathy as an important bed side tool.…”

Section: R Ationale and E Videncementioning

confidence: 99%

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

Chawla

Madhu

Makkar

et al. 2020

Indian J Endocr Metab

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Clinical diagnosis of distal diabetic polyneuropathy using neurological examination scores: correlation with nerve conduction studies

Cited by 6 publications

References 24 publications

Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus

Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus

RSSDI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2022

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

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