The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy.
This study assessed the sensitivity of various methods for the clinical diagnosis of diabetic peripheral neuropathy. A total of 147 randomly selected patients with diabetes mellitus and 65 age- and sex-matched healthy controls were evaluated by various clinical (the neuropathy symptom score [NSS], the neuropathy disability score [NDS], vibration perception thresholds [VPTs], Tinel's sign and Phalen's sign), laboratory (fasting plasma glucose and glycosylated haemoglobin levels) and electro-physiological (nerve conduction studies, H-reflex and F-wave measurements) methods. In the patient group, 8.2% had an abnormal NSS, 28.5% had a positive Phalen's sign, 32.6% had a positive Tinel's sign, 42.8% had an abnormal VPT and 57.1% had an abnormal NDS. Significant correlations were found between electro-physiologically confirmed neuropathy and the two provocation tests and abnormal VPTs. In conclusion, assessment with a complete neurological examination and standard electrophysiological tests is very important for the diagnosis of diabetic peripheral neuropathy and the prevention of morbidity in patients with or without symptoms.
Onde
M E
ME
Department of Endocrinology, GMMA Haydarpasa Training Hospital, Istanbul, Turkey. ondeemin@yahoo.com.tr
Ozge
A
A
Senol
M G
MG
Togrol
E
E
Ozdag
F
F
Saracoglu
M
M
Misirli
H
H
D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003940:Diagnostic Techniques, Endocrine; D004185:Disability Evaluation; D004568:Electrodiagnosis; D005260:Female; D006455:Hemoglobins, Abnormal / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010292:Paresthesia / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds
D006455:Hemoglobins, Abnormal; C048900:hemoglobin, glycerated