S S Gylfadottir1,2, M Itani3, T Krøigård3, A G Kristensen1,4, D H Christensen5, S K Nicolaisen5, P Karlsson1,6, B C Callaghan7, D L Bennett8, H Andersen2, H Tankisi4, J S Nielsen9, N T Andersen10, T S Jensen1,2, R W Thomsen5, S H Sindrup3, N B Finnerup1,2. 1. Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 2. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Neurology, Odense University Hospital, Odense, Denmark. 4. Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 6. Core Center for Molecular Morphology, Section for Stereology and Microscopy, Aarhus University, Aarhus, Denmark. 7. Department of Neurology, University of Michigan, Ann Arbor,, MI, USA. 8. Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK. 9. Danish Centre for Strategic Research in Type 2 Diabetes, Steno Diabetes Center, Odense, Denmark. 10. Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.
Abstract
BACKGROUND AND PURPOSE: Diabetic polyneuropathy (DPN) is a common complication of diabetes. Using the Toronto criteria for diabetic polyneuropathy and the grading system for neuropathic pain, the performance of neuropathy scales and questionnaires were assessed by comparing them to a clinical gold standard diagnosis of DPN and painful DPN in a cohort of patients with recently diagnosed type 2 diabetes. METHODS: A questionnaire on neuropathy and pain was sent to a cohort of 5514 Danish type 2 diabetes patients. A sample of 389 patients underwent a detailed clinical examination and completed neuropathy questionnaires and scales. RESULTS: Of the 389 patients with a median diabetes duration of 5.9 years, 126 had definite DPN (including 53 with painful DPN), 88 had probable DPN and 53 had possible DPN. There were 49 patients with other causes of polyneuropathy, neuropathy symptoms or pain, 10 with subclinical DPN and 63 without DPN. The sensitivity of the Michigan Neuropathy Screening Instrument questionnaire to detect DPN was 25.7% and the specificity 84.6%. The sensitivity of the Toronto Clinical Neuropathy Scoring System, including questionnaire and clinical examination, was 62.9% and the specificity was 74.6%. CONCLUSIONS: Diabetic polyneuropathy affects approximately one in five Danish patients with recently diagnosed type 2 diabetes but neuropathic pain is not as common as previously reported. Neuropathy scales with clinical examination perform better compared with questionnaires alone, but better scales are needed for future epidemiological studies.
BACKGROUND AND PURPOSE:Diabetic polyneuropathy (DPN) is a common complication of diabetes. Using the Toronto criteria for diabetic polyneuropathy and the grading system for neuropathic pain, the performance of neuropathy scales and questionnaires were assessed by comparing them to a clinical gold standard diagnosis of DPN and painful DPN in a cohort of patients with recently diagnosed type 2 diabetes. METHODS: A questionnaire on neuropathy and pain was sent to a cohort of 5514 Danish type 2 diabetespatients. A sample of 389 patients underwent a detailed clinical examination and completed neuropathy questionnaires and scales. RESULTS: Of the 389 patients with a median diabetes duration of 5.9 years, 126 had definite DPN (including 53 with painful DPN), 88 had probable DPN and 53 had possible DPN. There were 49 patients with other causes of polyneuropathy, neuropathy symptoms or pain, 10 with subclinical DPN and 63 without DPN. The sensitivity of the Michigan Neuropathy Screening Instrument questionnaire to detect DPN was 25.7% and the specificity 84.6%. The sensitivity of the Toronto Clinical Neuropathy Scoring System, including questionnaire and clinical examination, was 62.9% and the specificity was 74.6%. CONCLUSIONS:Diabetic polyneuropathy affects approximately one in five Danish patients with recently diagnosed type 2 diabetes but neuropathic pain is not as common as previously reported. Neuropathy scales with clinical examination perform better compared with questionnaires alone, but better scales are needed for future epidemiological studies.
Authors: Andreas C Themistocleous; Alexander G Kristensen; Roma Sola; Sandra S Gylfadottir; Kristine Bennedsgaard; Mustapha Itani; Thomas Krøigård; Lise Ventzel; Søren H Sindrup; Troels S Jensen; Hugh Bostock; Jordi Serra; Nanna B Finnerup; Hatice Tankisi; David L H Bennett Journal: Ann Neurol Date: 2022-03-07 Impact factor: 11.274
Authors: Troels S Jensen; Pall Karlsson; Sandra S Gylfadottir; Signe T Andersen; David L Bennett; Hatice Tankisi; Nanna B Finnerup; Astrid J Terkelsen; Karolina Khan; Andreas C Themistocleous; Alexander G Kristensen; Mustapha Itani; Søren H Sindrup; Henning Andersen; Morten Charles; Eva L Feldman; Brian C Callaghan Journal: Brain Date: 2021-07-28 Impact factor: 13.501
Authors: Pall Karlsson; Sandra S Gylfadottir; Alexander G Kristensen; Juan D Ramirez; Pedro Cruz; Nhu Le; Pallai R Shillo; Solomon Tesfaye; Andrew S C Rice; Hatice Tankisi; Nanna B Finnerup; Jens R Nyengaard; Troels S Jensen; David L H Bennett; Andreas C Themistocleous Journal: Diabetologia Date: 2021-01-23 Impact factor: 10.122
Authors: Thomas Krøigård; Sandra S Gylfadottir; Mustapha Itani; Karolina S Khan; Henning Andersen; Søren H Sindrup; Troels S Jensen; Kjeld V Andersen; Hatice Tankisi; Sándor Beniczky; Alexander Gramm Kristensen Journal: Clin Neurophysiol Pract Date: 2021-09-02