Comparison of the Diagnostic Yields of Some Methods of Screening for Diabetic Peripheral Neuropathy in North Central Nigeria

Abstract

Background: Peripheral neuropathy is one of the microvascular complications of diabetes mellitus, a risk factor for diabetic foot, and a major cause of disability world wide. Several authors have variedly reported on the efficacies of the different simple and sophisticated methods used in the diagnosis of peripheral neuropathy. The aim of this study is to compare the diagnostic yields of different simple methods of screening for diabetic peripheral neuropathy.
 Methodology: This is a multi-center cross-sectional study involving 1040 participants recruited consecutively, following consent. Relevant biodata and medical history were obtained, while physical examinations including anthropometry, and blood glucose levels were done for each participant. History of paresthesia, 10g monofilament test, vibration test using 128Hz tuning fork, and ankle reflex assessment were the methods used to screen for diabetic peripheral neuropathy. Student ‘t’ test and chi square were used to compare continuous and categorical variables respectively. Significant p-value was put at less than or equal to 0.05.
 Results: The percentage of participants with positive screen for diabetic peripheral neuropathy based on the different methods include: positive neuropathic symptoms (64%), negative neuropathic symptoms (50.7%), 10g monofilament testing (31.9%), vibration sensation by tuning fork (21.8%), and ankle reflex impairment (13.1%). A total of 80.1% of the participants were screened positive for diabetic peripheral neuropathy when all the methods were used.
 Conclusion: Positive and negative neuropathic symptoms have higher diagnostic yields for diabetic peripheral neuropathy screening than 10g monofilament testing, vibration sensation using tuning fork, and ankle reflex examination. However, it is encouraged to use all available methods to screen for diabetic peripheral neuropathy, as this increases the diagnostic yield, and ensure early adoption of preventive and therapeutic strategies.