F Y Jie1,2, M I Zafar1, L Xu2, R A Shafqat3, F Gao1. 1. Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China. 2. Department of Intensive Care Unit, Wuhan Third Hospital, Wuhan, China. 3. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Abstract
CONTEXT: Diabetic peripheral neuropathy (DPN) is a common complication associated with long-term type 2 diabetes mellitus, although early diagnosis can improve prognosis. OBJECTIVE: Our objective was to develop a simple protocol for early diagnosis of DPN in Chinese type 2 diabetic patients. SUBJECTS AND METHODS: A total of 209 type 2 diabetic patients were included; these patients were categorized as symptomatic and asymptomatic group based on their symptoms. Clinical data of these patients were recorded and they were screened for DPN by vibration perception threshold test (VPT), 10-G nylon monofilament test, temperature identification, and the tendon reflex test. RESULTS: The total combined rate of patients who were tested positive for DPN with all four screening methods was 68.7%. Patients tested positive for DPN were significantly older and had a longer disease duration than those who were tested negative (p<0.01); however, glycated hemoglobin levels, presence of hypertension, and gender did not differ significantly between them (p>0.05). Among screening methods, the highest positive rate observed among patients screened with the VPT test was 63.64% as compared to other tests. The total positive rate for temperature discrimination, 10-G monofilament and tendon reflex test were 26.79%, 11.96 % and 17.22 % respectively. In asymptomatic group VPT showed the highest positive rate for DPN (48.41%). CONCLUSIONS: The combination of four simple methods can improve the detection rate of DPN and identify subclinical cases. Abnormal vibration perception was the most common feature of DPN and it was associated with both disease duration and the age of the patient.
CONTEXT: Diabetic peripheral neuropathy (DPN) is a common complication associated with long-term type 2 diabetes mellitus, although early diagnosis can improve prognosis. OBJECTIVE: Our objective was to develop a simple protocol for early diagnosis of DPN in Chinese type 2 diabetic patients. SUBJECTS AND METHODS: A total of 209 type 2 diabetic patients were included; these patients were categorized as symptomatic and asymptomatic group based on their symptoms. Clinical data of these patients were recorded and they were screened for DPN by vibration perception threshold test (VPT), 10-G nylon monofilament test, temperature identification, and the tendon reflex test. RESULTS: The total combined rate of patients who were tested positive for DPN with all four screening methods was 68.7%. Patients tested positive for DPN were significantly older and had a longer disease duration than those who were tested negative (p<0.01); however, glycated hemoglobin levels, presence of hypertension, and gender did not differ significantly between them (p>0.05). Among screening methods, the highest positive rate observed among patients screened with the VPT test was 63.64% as compared to other tests. The total positive rate for temperature discrimination, 10-G monofilament and tendon reflex test were 26.79%, 11.96 % and 17.22 % respectively. In asymptomatic group VPT showed the highest positive rate for DPN (48.41%). CONCLUSIONS: The combination of four simple methods can improve the detection rate of DPN and identify subclinical cases. Abnormal vibration perception was the most common feature of DPN and it was associated with both disease duration and the age of the patient.
Entities:
Keywords:
Diabetic peripheral neuropathy; monofilament; temperature identification; tendon reflex; type 2 diabetes; vibration perception threshold
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