Diagnostic accuracy of monofilament test to detect diabetic neuropathy

Shrestha, Sujan; Gorhaly, Mamen Prasad; Bajracharya, Manil

doi:10.3126/jaim.v10i1.37086

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…The monofilament testing detected neuropathy in 22 (21.0%) (CI:14.3-29.7) participants similar to a study by Shrestha S et al 13 where it was 27.1%.…”

Section: Discussionsupporting

confidence: 84%

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

Deekshanya J,

Ali H F,

Roselin M

et al. 2024

IJCEO

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Screening of asymptomatic diabetes mellitus (DM) patients may reduce future complications. Despite having diabetic peripheral neuropathy (DPN), about 50% of type 2 diabetes mellitus (type 2 DM) patients are asymptomatic. If diabetic neuropathy is diagnosed early, the annual cost of treating diabetic neuropathy and associated complications can be decreased. The study objectives are to identify peripheral neuropathy at an early stage and to correlate peripheral neuropathy with diabetic retinopathy and HbA1c (glycated haemoglobin) in asymptomatic type 2 DM patients.: A cross-sectional analytical study was done during July and August 2022 using consecutive sampling on 105 patients who attended the General Medicine out-patient dept (OPD) at Pondicherry Institute of Medical Sciences and the Primary Health Centre (PHC) Kalapet in Puducherry, India. Patients over 18 years old with type 2 DM, who were asymptomatic for peripheral neuropathy, and had their HbA1c levels checked within the last two months were included. Patients have undergone Michigan Neuropathy Screening Instrument (MNSI) examination, biothesiometer and monofilament testing for neuropathy and Fundus examination for retinopathy. The average age of the study participants was 54.7±11.4 yrs, and they had a male-female ratio of 6:4. The retinopathy was present in 18.1% (95% CI:11.9-26.5). The prevalence of DPN by MNSI examination was 3.8% (95% CI:1.5-9.4), monofilament testing was 21.0% (95% CI:14.3-29.7) and biothesiometer was 98.1% (95% CI:93.3-99.5). A statistically significant association between DPN measured by a biothesiometer and HbA1c (p<0.05). There was no significant correlation between DR and HbA1c and between DPN measured by monofilament and HbA1c (p>0.05).The objective assessment by the biothesiometer is the best tool for detecting peripheral neuropathy at an early stage in asymptomatic type 2 DM individuals than monofilament testing.

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“…The monofilament testing detected neuropathy in 22 (21.0%) (CI:14.3-29.7) participants similar to a study by Shrestha S et al 13 where it was 27.1%.…”

Section: Discussionsupporting

confidence: 84%

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

Deekshanya J,

Ali H F,

Roselin M

et al. 2024

IJCEO

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“…Convenience sampling was done and the sample size was calculated by the appropriate formula. 28 Using the calculator at www.riskcalc.org/samplesize/ for determining area under ROC curve with an alpha error of 0.05, power of 90%, null hypothesis Area under Curve (AUC) value of 0.5 and considering the prevalence of DPN to be 0.45 in diabetic Indian participants, 1 the sample size required was 42. However, we could include as many as 149 patients in the final analysis.…”

Section: Methodsmentioning

confidence: 99%

Can the 128-Hz tuning fork be an alternative to the biothesiometer for diabetic peripheral neuropathy screening? A cross-sectional study in a tertiary hospital in East India

Chattopadhyay,

Goswami,

Sengupta

et al. 2024

BMJ Open

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IntroductionDiabetic neuropathy is frequently underdiagnosed and undertreated. Logistic problems accompany the routine use of the biothesiometer. Hence, we attempted to find a more easily available alternative.Research design and methods149 patients with diabetes visiting the outpatient endocrinology clinic were assessed for vibration sense using a 128-Hz tuning fork (absolute timing method) and a biothesiometer. A reading of >25 V on the biothesiometer (known as vibration perception threshold or VPT) was taken as the diagnostic criterion for severe neuropathy while >15 V was used as an indicator of the mild form. The sensitivity and specificity were calculated by constructing the receiver operating characteristic curve (ROC). A p value of <0.05 was considered as statistically significant.ResultsThe timed tuning fork (TTF) test showed a statistically significant correlation with the VPT measurements (r=−0.5, p=0.000). Using the VPT findings as a reference, a timed tuning fork cut-off of 4.8 s was 76% sensitive and 77% specific in diagnosing mild neuropathy while absent tuning fork sensation demonstrated 70% sensitivity and 90% specificity in detecting severe neuropathy.ConclusionsThe tuning fork test demonstrated significant sensitivity and specificity in diagnosing diabetic peripheral neuropathy when compared against the biothesiometer. A cut-off of 4.8 s can be a useful indicator of the early stages of onset of the condition.

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“…The instruments used in this study were visual analog scale (VAS), monofilament, and foot Doppler. [5][6][7] Permission was obtained to carry out this study from the Ethics Committee for Health and Medical Research, Faculty of Medicine, University of Brawijaya.…”

Section: Design and Methodsmentioning

confidence: 99%

Correlation of leg pain responses with ankle-brachial index and peripheral sensory responses in foot of type 2 diabetes mellitus

Kristianto

Nasution²,

Fatma³

et al. 2023

HEALTHC LOW-RESOUR S

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Introduction: Type 2 Diabetes Mellitus (T2DM) is associated with changes that occur in the peripheral circulation that affect foot functions. Therefore, there is a need for a risk prediction test on foot abnormalities using the leg pain response parameters in T2DM patients with ankle-brachial index (ABI) and peripheral sensory changes as a preventive effort to manage foot care. Design and Methods: This study employed a cross-sectional design in which 63 T2DM patients in a Public Health Center (PHC) in Malang were investigated. The instruments used include visual analog scale (VAS), monofilament, and foot doppler. Results: The Pearson correlation test showed no relationship between the responses to leg pain and the ABI of the right and left feet (p-values = 0.217 and 0.692), but there was a significant relationship between the left foot ABI and sensory status (p-value 0.002; left foot r = 0.383). Meanwhile, the Pearson's correlation and linear regression test also showed a relationship between the right foot ABI and sensory status (p-value = 0.007; r = 0.338). Furthermore, a multiple linear regression test showed a relationship between the leg pain response and sensory perception of the right and left feet (p-value = 0.035; r = 0.325). Conclusions: The relationship between the sensory status of the right and left feet and the response to leg pain in T2DM patients were moderate with a negative direction. It, therefore, implies that a decrease in the sensory responses increased the leg pain. Meanwhile, the moderate relationship and positive direction between the ABI and sensory status of the feet of T2DM patients indicates that a higher ABI score led to an increase in the sensory status of the foot.

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Diagnostic accuracy of monofilament test to detect diabetic neuropathy

Cited by 4 publications

References 18 publications

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

Can the 128-Hz tuning fork be an alternative to the biothesiometer for diabetic peripheral neuropathy screening? A cross-sectional study in a tertiary hospital in East India

Correlation of leg pain responses with ankle-brachial index and peripheral sensory responses in foot of type 2 diabetes mellitus

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