Scoring systems to screen for diabetic peripheral neuropathy

Yang, Zhirong; Chen, Ru; Yuan, Zuyi; Huang, Yuansheng; Hong, Tianpei; Sun, Feng; Ji, Linong; Zhan, Siyan

doi:10.1002/14651858.cd010974

Cited by 28 publications

(20 citation statements)

References 65 publications

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“…NDS is a validated clinical score with a high sensitivity and specificity for the diagnosis of distal symmetric polyneuropathy [ 21 , 22 ]. Patients with an NDS ≥ 6 points are considered to display abnormal reactions [ 8 , 10 , 23 ]. Furthermore, an NDS ≥ 6 has been shown associated with an increased risk of foot ulceration [ 24 – 27 ], poor glycemic control, and microvascular complications [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of electrochemical skin conductance and vibration perception threshold measurement in the detection of early diabetic neuropathy

et al. 2017

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The early diagnosis of diabetic peripheral neuropathy (DPN) is challenging. Sudomotor dysfunction is one of the earliest detectable abnormalities in DPN. The present study aimed to determine the diagnostic performance of the electrochemical skin conductance (ESC) test in detecting early DPN, compared with the vibration perception threshold (VPT) test and diabetic neuropathy symptom (DNS) score, using the modified neuropathy disability score (NDS) as the reference standard. Five hundred and twenty-three patients with type 2 diabetes underwent an NDS-based clinical assessment for neuropathy. Participants were classified into the DPN and non-DPN groups based on the NDS (≥ 6). Both groups were evaluated further using the DNS, and VPT and ESC testing. A receiver-operator characteristic (ROC) curve analysis was performed to compare the efficacy of ESC measurements with those of DNS and VPT testing in detecting DPN. The DPN group (n = 110, 21%) had significantly higher HbA1c levels and longer diabetes durations compared with the non-DPN group (n = 413). The sensitivity of feet ESC < 60 μS, VPT testing, and DNS in detecting DPN were 85%, 72%, and 52%, respectively. The specificity of feet ESC, VPT, and DNS in detecting DPN were 85%, 90% and 60% respectively. The areas under the curves of the ROC plots for feet ESC, VPT testing, and DNS were 0.88, 0.84, and 0.6, respectively. A significant inverse linear relationship was noted between VPT and feet ESC (r = -0.45, p = <0.0001). The odds ratios for having DPN, based on the mean feet ESC testing < 60 μS, VPT testing > 15 V, and DNS ≥ 1, were 16.4, 10.9 and 1.8, respectively. ESC measurement is an objective and sensitive technique for the early detection of DPN. Feet ESC measurement was superior to VPT testing for identifying patients with early DPN.

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Section: Discussionmentioning

confidence: 99%

“…Various clinical scoring systems and bedside tests have been employed for DPN detection [ 8 , 9 ]. However, the commonly used tests tend to diagnose the condition only when it is well-established and preventive measures cannot be implemented [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of electrochemical skin conductance and vibration perception threshold measurement in the detection of early diabetic neuropathy

et al. 2017

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“…Neuropathy was evaluated by testing sensory perceptions of light touch using a 10-g monofilament, pain sensation using pinprick, vibration sense using a tuning fork of 128 Hz and a biothesiometer from Genesis medical systems, temperature sense, and ankle jerk. The neuropathy disability score (NDS)[17] was calculated to assess the severity of neuropathy [Table 1].…”

Section: Methodsmentioning

confidence: 99%

Platelet Indices as a Predictor of Microvascular Complications in Type 2 Diabetes

Walinjkar

Khadse

Sricharan

et al. 2019

Indian J Endocr Metab

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Background: Type 2 diabetes mellitus (T2DM) patients have a higher risk of developing micro- and macrovascular complications, which lead to decrease in the quality of life and increase in morbidity. Platelet indices have been available in the laboratory routine using blood cell counters for several years. These indices could alert us regarding endothelial dysfunction and in turn regarding the microvascular complications. Hence, this study was done to prove the correlation between platelet indices and microvascular complications in T2DM. Materials and Methods: In total, 125 diabetic patients attending diabetes OPD and admitted in medicine department along with age and sex-matched non-diabetic controls were studied. A detailed history was taken regarding duration of diabetes, medication, past history of stroke, IHD, and hypertension. Patients with T2DM were specially evaluated for microvascular complications. Platelet indices, fasting blood glucose, Post prandial blood glucose, HbA1C, and Sr. Creatinine were obtained from venous blood samples. All parameters were then subjected to statistical analysis using SPSS 17.0. Results: Platelet indices, namely MPV, PCT, PDW, and P/LCR were significantly higher in diabetic individuals than those in age and gender-matched controls. Moreover, the increase in MPV, PDW, and P/LCR was more significant in diabetic subjects with microvascular complications when compared with those without microvascular complications. Platelet dysfunction also showed a positive association with HbA1C, retinopathy, nephropathy, and neuropathy individually. Conclusions: Changes in platelet indices were found to be statistically associated with diabetes and its complications.

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“…As one of the common complications of diabetes mellitus (DM), diabetic peripheral neuropathy (DPN) is an important reason for foot ulceration, as well as morbidity and mortality [1,2]. It occurs in patients who have type I or type II DM [3].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Neuropathy Symptom and Change Score, Neuropathy Impairment Score and Michigan Neuropathy Screening Instrument for Diabetic Peripheral Neuropathy

Xiong

et al. 2015

Eur Neurol

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Aims: This study aims to evaluate the diagnostic capabilities of neuropathy symptom and change (NSC) score, neuropathy impairment score (NIS) and Michigan neuropathy screening instrument (MNSI) in diagnosing diabetic peripheral neuropathy (DPN). Methods: A total of 131 patients with type II diabetes received NSC, NIS and MNSI scoring systems. Electromyography/nerve conduction velocity (EMG/NCV) test was taken as gold standard. Correlations between EMG/NCV test and the 3 scorings, and their sensitivity, specificity, positive and negative predictive values, accuracy and kappa (κ) value were analyzed. Results: The prevalence of DPN was 43.5% according to EMG/NCV findings. EMG/NCV test was significantly positive correlated with all the 3 scorings, highest with NIS scoring (r = 0.653, p < 0.001). Compared with EMG/NCV test, NSC score was most sensitive (85.96%) but least specific (77.03%); NIS score had lower sensitivity (59.65%) but best specificity (98.65%) and accuracy (81.68%). Both had high concordance with EMG/NCV test (κ = 0.61). Sensitivity, specificity and accuracy of MNSI were highest (70.18, 98.65 and 80.15%) at the cutoff values of >1.0, >2.5 and >1.5, respectively (κ = 0.58). Conclusions: Both NSC and NIS were accurate and reliable diagnostic methods for DPN. The combined application of NSC and NIS was recommended in DPN diagnosis.

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Scoring systems to screen for diabetic peripheral neuropathy

Cited by 28 publications

References 65 publications

Comparison of electrochemical skin conductance and vibration perception threshold measurement in the detection of early diabetic neuropathy

Comparison of electrochemical skin conductance and vibration perception threshold measurement in the detection of early diabetic neuropathy

Platelet Indices as a Predictor of Microvascular Complications in Type 2 Diabetes

The Diagnostic Value of Neuropathy Symptom and Change Score, Neuropathy Impairment Score and Michigan Neuropathy Screening Instrument for Diabetic Peripheral Neuropathy

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