Comparison of Efficiencies of Neurological Physical Examination, Neurothesiometer and PainDETECT Questionnaire in Diagnosing Diabetic Neuropathy

Hajrah Ahsan; Talha Kareem; Salma Tanveer; Muhammad Farrukh Aftab; Bahawal zeb; Ahmed Kabir

doi:10.37978/tijfs.v4i1.59

Authors

Hajrah Ahsan Department of general medicine, Nishtar hospital, Multan Pakistan Author
Talha Kareem Department of General Surgery, Nishtar Hospital, Multan, Pakistan Author
Salma Tanveer Department of general medicine, Nishtar hospital, Multan Pakistan Author
Muhammad Farrukh Aftab Department of General Surgery, Nishtar Hospital, Multan, Pakistan Author
Bahawal zeb Department of General Medicine, Combined Military Hospital, Multan, Pakistan Author
Ahmed Kabir Department of general medicine, Nishtar hospital, Multan Pakistan Author

DOI:

https://doi.org/10.37978/tijfs.v4i1.59

Keywords:

Diabetic Neuropathy, MNSI, Neurothesiometer, Pain DETECT

Abstract

Objective: To compare the efficacies of neurological physical examination, neurothesiometer and PainDETECT questionnaire in diagnosing diabetic neuropathy.

Study Design: Prospective cross-sectional

Place and Duration of Study: Department of General Medicine, Nishtar Hospital Multan, Pakistan from 1^st December 2018 to 10^th March 2019.

Materials and Methods: One hundred and four patients of both type 1 and type 2 diabetes visiting the outdoor department were included in this study. They were assessed by lab results of glycosylated hemoglobin, fasting and random blood sugar levels and neurological physical examination.

Results: The physical examination with Michigan Neuropathy Screening instrument showed that around 29 of the patients were having established neuropathy. The PainDETECT questionnaire on the other hand showed about 42 patients having a definitive neuropathy while the neurothesiometer showed that 79 of the total patients had varying degrees of neuropathy.

Conclusion: The neurothesiometer is a better diagnostic tool for diagnosing diabetic neuropathy in patients.

References

Dyck PJ, Davies JL, Wilson DM, Service FJ, Melton LJ, 3rd, O'Brien PC. Risk factors for severity of diabetic polyneuropathy: intensive longitudinal assessment of the Rochester Diabetic Neuropathy Study cohort. Diabetes Care 1999;22(9):1479-86.

Vincent AM, Russell JW, Low P, Feldman EL. Oxidative stress in the pathogenesis of diabetic neuropathy. Endocrine Rev 2004;25(4):612-28.

Oates PJ. Polyol pathway and diabetic peripheral neuropathy. Int Rev Neurobiol 2002;50:325-92.

Cameron NE, Eaton S, Cotter MA, Tesfaye S. Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. Diabetologia 2001;44(11):1973-88.

Yagihashi S, Yamagishi S-I, Wada R. Pathology and pathogenetic mechanisms of diabetic neuropathy: correlation with clinical signs and symptoms. Diabetes Res Clin Prac 2007;77(3):S184-S9.

Mete T, Aydin Y, Saka M, Cinar Yavuz H, Bilen S, Yalcin Y, et al. Comparison of efficiencies of Michigan neuropathy screening instrument, neurothesiometer, and electromyography for diagnosis of diabetic neuropathy. Int J Endocrinol 2013;2013.

Nisar MU, Asad A, Waqas A, Ali N, Nisar A, Qayyum MA, et al. Association of Diabetic Neuropathy with Duration of Type 2 Diabetes and Glycemic Control. Cureus 2015;7(8):e302-e.

Callaghan BC, Hur J, Feldman EL. Diabetic neuropathy: one disease or two? Curr Opin Neurol 2012;25(5):536.

Smith AG, Singleton JR. Obesity and hyperlipidemia are risk factors for early diabetic neuropathy. J Diabetes Complications 2013;27(5):436-42.

Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med 2005;352(4):341-50.

Herman W, Pop-Busui R, Braffett B, Martin C, Cleary P, Albers J, et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabetic Med 2012;29(7):937-44.

Vollert J, Kramer M, Barroso A, Freynhagen R, Haanpaa M, Hansson P, et al. Symptom profiles in the PainDETECT Questionnaire in patients with peripheral neuropathic pain stratified according to sensory loss in quantitative sensory testing. Pain 2016;157(8):1810-8.

Freynhagen R, Tölle TR, Gockel U, Baron R. The PainDETECT project–far more than a screening tool on neuropathic pain. Curr Med Res Opin 2016;32(6):1033-57.

Bril V, Kojic J, Ngo M, Clark K. Comparison of a neurothesiometer and vibration in measuring vibration perception thresholds and relationship to nerve conduction studies. Diabetes care 1997;20(9):1360-2.

Kincaid JC, Price KL, Jimenez MC, Skljarevski V. Correlation of vibratory quantitative sensory testing and nerve conduction studies in patients with diabetes. Muscle Nerve 2007;36(6):821-7.