Variability in the clinical diagnosis of diabetic peripheral neuropathy

Chicharro‐Luna, Esther; Pomares, Francisco; Ortega-Ávila, Ana Belén; Coheña‐Jiménez, Manuel; Gijón-Noguerón, Gabriel

doi:10.1016/j.pcd.2019.05.008

Cited by 25 publications

(27 citation statements)

References 35 publications

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“…A small-fiber neuropathy has been associated with neuropathic pain and the fibers are believed to be damaged earliest during the diabetes condition [ 47 ]. However, the clinical diagnosis of DPN using the pinprick test has a lower sensitivity than the tuning fork and the monofilament test in four areas of the foot [ 48 ]. Moreover, the combinations of more than one test was suggested for the more sensitive detection of DPN (>87%) [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Thai version of the Questionnaire for Diabetes-Related Foot Disease (Thai Q-DFD): validity and reliability

Thungtak

Wannapakhe

Lapanantasin

2021

Heliyon

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Aims To reduce diabetic foot complications, an annual screening of diabetes-related foot disease (DRFD) should be promoted. The screening tool as the Thai translated Questionnaire for Diabetes-related Foot Disease, Thai Q-DFD, has been established. The study was designed to assess the validity and reliability of the Thai Q-DFD before practical use in the community. Methods One hundred and thirty-nine persons with diabetes volunteered in a concurrent validity testing for agreement in diagnosis between the Thai Q-DFD and the standard clinical examinations. The test-retest reliability (a stability of a tool over time between three days apart) was assessed in 50 volunteers. The agreement in either validity or reliability test was evaluated using kappa coefficient. Results The screening diagnosis as DRFD by the Thai Q-DFD substantially agreed with that by the standard clinical examinations (kappa = 0.71). The Thai Q-DFD also showed high sensitivity (0.92) and specificity (0.78). Additionally, the Thai Q-DFD presented good test-retest reliability for DRFD diagnosis (kappa = 0.74). Conclusions The Thai Q-DFD is comparable to the original English version in terms of concurrent validity and test-retest reliability. Therefore, it can be used for a screening of DRFD in Thai people.

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Section: Discussionmentioning

confidence: 99%

Thai version of the Questionnaire for Diabetes-Related Foot Disease (Thai Q-DFD): validity and reliability

Thungtak

Wannapakhe

Lapanantasin

2021

Heliyon

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“…[ 1 ] It is the most prevalent chronic complication of diabetes and glucose control has been considered very important in the prevention of diabetic neuropathy. [ 2 ] Besides glucose control, early diagnosis of DPN would help in the timely management of complications and would prevent further morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Semmes Weinstein 10 gm monofilament in diabetic peripheral neuropathy taking nerve conduction and autonomic function study as reference tests

Dube

Hulke

Wakode

et al. 2022

Journal of Family Medicine and Primary Care

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Context: Diabetic peripheral neuropathy (DPN) if detected early can reduce the burden on the health system and prevent the development of diabetic foot ulcers and amputation. Aim: To study the effectiveness of Semmes Weinstein 10 gm monofilament in detecting DPN taking nerve conduction studies (NCS) and autonomic function testing (AFT) as reference tests. Settings and Design: Observational and comparative cross-sectional study conducted in the Physiology department AIIMS, Bhopal in collaboration with the Medicine department of the institute. Methods and Material: A total of 72 diagnosed type-2 diabetes mellitus patients were examined using Semmes Weinstein 10 gm monofilament, DPN was confirmed using NCS (Nihon Kohden Neuropack XI machine) and autonomic neuropathy was confirmed using AFT (Ewing’s battery and Power lab) with heart rate variability (HRV). Diagnostic value of Semmes Weinstein 10 gm monofilament taking NCS and AFT as reference test was calculated. Statistical Analysis Used: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated using the standard formula. Results: Sensitivity, specificity, PPV, and NPV using monofilament are 69.23%, 20%, 69.23% and 20% respectively taking NCS as reference test and 70.59%, 0, 92.30%, and 0 respectively taking AFT as reference test. Conclusions: Semmes Weinstein 10 gm monofilament is not the ideal screening test for the diagnosis of DPN. Sole clinical use of monofilament should be discouraged.

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“…However, risk prediction model for diabetic neuropathy among DM patients have not been developed in Ethiopia. There was variability in the clinical diagnosis of diabetic neuropathy in different setting (30). Thus, this prediction model considers prognostic factors that have been generally monitored in clinical practice and precisely measured to ensure its feasibility and accuracy for clinical application.…”

Section: Introductionmentioning

confidence: 99%

Prediction of the risk for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, January, 2005- December 2021; Development and validation of risk prediction model

Gelaw¹,

Muche

Alem

et al. 2022

Preprint

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Background:-Diabetic neuropathy is the most common complication in both Type-1 and Type-2 DM patients with more than one half of all patients developing nerve dysfunction in their lifetime. Although, risk prediction model was developed for diabetic neuropathy in developed countries, It is not applicable in clinical practice, due to poor data, methodological problems, inappropriately analyzed and reported. To date, no risk prediction model developed for diabetic neuropathy among DM in Ethiopia, Therefore, this study aimed prediction the risk of diabetic neuropathy among DM patients, used for guiding in clinical decision making for clinicians Objective:- Prediction of the risk for diabetic neuropathy among diabetes mellitus patients, in selected referral hospitals, Amhara regional state, northwest Ethiopia,2022 Methods:- A retrospective follow up study was conducted with a total of 808 DM patients were enrolled from January 1,2005 to December 30,2021 at two selected referral hospitals in Amhara regional state. Multi-stage sampling techniques were used and the data was collected by checklist from medical records by Kobo collect and exported to STATA version-17 for analysis. Lasso method were used to select predictors and entered to multivariable logistic regression with P-value<0.05 was used for nomogram development. Model performance was assessed by AUC and calibration plot. Internal validation was done through bootstrapping method and decision curve analysis was performed to evaluate net benefit of model Results:-The incidence proportion of diabetic neuropathy among DM patients was 21.29 %( 95% CI; 18.59, 24.25).In multivariable logistic regression glycemic control, other comorbidities, physical activity, hypertension, alcohol drinking, type of treatment , white blood cells and red blood cells count were statistically significant. Nomogram was developed, has discriminating power AUC; 73.2 %( 95% CI; 69.0%, 77.3%) and calibration test (P-value = 0.45). It was internally validated by bootstrapping method with discrimination performance 71.7(95% CI; 67.2 %, 75.9%).It had less optimism coefficient (0.015).To make nomogram accessible, mobile based tool were developed. In machine learning, classification and regression tree has discriminating performance of 70.2 %( 95 % CI; 65.8%, 74.6%).The model had high net benefit at different threshold probabilities in both nomogram and classification and regression tree. Conclusion:- The developed nomogram and decision tree, has good level of accuracy and well calibration, easily individualized prediction of diabetic neuropathy. Both models had added net benefit in clinical practice and to be clinically applicable mobile based tool were developed.

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Variability in the clinical diagnosis of diabetic peripheral neuropathy

Cited by 25 publications

References 35 publications

Thai version of the Questionnaire for Diabetes-Related Foot Disease (Thai Q-DFD): validity and reliability

Thai version of the Questionnaire for Diabetes-Related Foot Disease (Thai Q-DFD): validity and reliability

Effectiveness of Semmes Weinstein 10 gm monofilament in diabetic peripheral neuropathy taking nerve conduction and autonomic function study as reference tests

Prediction of the risk for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, January, 2005- December 2021; Development and validation of risk prediction model

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