[Selection of risk and diagnosis in diabetic polyneuropathy. Validation of method of new systems].
BACKGROUND
In a previous study we developed a specific algorithm, the polyneuropathy selection method (PSM) with 4 parameters (age, HDL-C, HbA1c, and retinopathy), to select patients at risk of diabetic polyneuropathy (DPN). We also developed a simplified method for DPN diagnosis: outpatient polyneuropathy diagnosis (OPD), with 4 variables (symptoms and 3 objective tests).


OBJECTIVE
To confirm the validity of conventional tests for DPN diagnosis; to validate the discriminatory power of the PSM and the diagnostic value of OPD by evaluating their relationship to electrodiagnosis studies and objective clinical neurological assessment; and to evaluate the correlation of DPN and pro-inflammatory status.


METHODS
Cross-sectional, crossed association for PSM validation. Paired samples for OPD validation.


METHODS
Primary care in 3 counties.


METHODS
Random sample of 75 subjects from the type-2 diabetes census for PSM evaluation. Thirty DPN patients and 30 non-DPN patients (from 2 DM2 sub-groups in our earlier study) for OPD evaluation.


METHODS
The gold standard for DPN diagnosis will be studied by means of a clinical neurological study (symptoms, physical examination, and sensitivity tests) and electrodiagnosis studies (sensitivity and motor EMG). Risks of neuropathy, macroangiopathy and pro-inflammatory status (PCR, TNF soluble fraction and total TGF-beta1) will be studied in every subject.


RESULTS
Electrodiagnosis studies should confirm the validity of conventional tests for DPN diagnosis. PSM and OPD will be valid methods for selecting patients at risk and diagnosing DPN. There will be a significant relationship between DPN and pro-inflammatory tests.
Jurado
Jerónimo
J
Enfermería, Equipo de Atención Primaria, ABS Olot, Instituto Catalán de la Salud, Olot, Girona, España. p415ujjc@pgirona.scs.es
Caula
Jacinto
J
Pou i Torelló
Josep Maria
JM
D000465:Algorithms; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000517:prevention & control; D004576:Electromyography; D006801:Humans; D007258:Informed Consent; D009460:Neurologic Examination; D018579:Patient Selection; D010808:Physical Examination; D010865:Pilot Projects; D011320:Primary Health Care; D012372:ROC Curve; D012307:Risk Factors; D012494:Sampling Studies