title: A clinical screening score for diabetic polyneuropathy: KORA F4 and AusDiab studies.
abstract: OBJECTIVE
  Since screening for distal sensorimotor polyneuropathy (DSPN) in individuals with diabetes is being underused, our aim was to develop a clinical screening score for identifying individuals with DSPN.
  
  
  METHODS
  All participants with type 2 diabetes and aged 61-82 years from the German population-based KORA F4 Study (n=177) and the Australian population-based AusDiab Study (n=244) were combined into one study sample. Risk indicators of DSPN were identified and entered into a stepwise model-selection procedure, constructing two consecutive scores with increasing complexity (a base and clinical model).
  
  
  RESULTS
  The prevalence of DSPN was 18.2% (95% confidence interval (CI): 14.7-22.3). The base model comprised age (years), height (cm), weight (kg), pain or discomfort in the feet and/or legs (yes/no), and duration of diabetes (years), yielding an area under the receiver operating characteristics curve (AUC) of 0.80 (95% CI: 0.76-0.85). The clinical model additionally included diastolic blood pressure (mmHg) and serum creatinine levels (mmol/l). The AUC increased only marginally to 0.82 (0.77-0.87) (p for AUC comparison=0.188). The internal validation of the scores produced similar AUCs.
  
  
  CONCLUSIONS
  The screening scores developed in this study are a simple tool to differentiate between a high and low likelihood of having DSPN among individuals with type 2 diabetes.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany. Electronic address: brenda.bongaerts@ddz.uni-duesseldorf.de.
authors.forename: B W C
authors.initials: BW
authors.lastname: Bongaerts
authors.affiliation: Department of Endocrinology and Diabetology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), partner Düsseldorf, Auf´m Hennekamp 65, 40225 Germany.
authors.forename: D
authors.initials: D
authors.lastname: Ziegler
authors.affiliation: Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Shaw
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Heier
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kowall
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), partner Düsseldorf, Auf´m Hennekamp 65, 40225 Germany.
authors.forename: C
authors.initials: C
authors.lastname: Herder
authors.affiliation: Department of Endocrinology and Diabetology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), partner Düsseldorf, Auf´m Hennekamp 65, 40225 Germany.
authors.forename: M
authors.initials: M
authors.lastname: Roden
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Peters
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Meisinger
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf´m Hennekamp 65, 40225 Düsseldorf, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Rathmann
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007391:International Cooperation; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D001786:Blood Glucose
keywords: Australia; Diabetes mellitus; Distal sensorimotor polyneuropathy; Epidemiology; Germany; Screening score