Evaluation of the Frequency of Polyneuropathy Based Upon the Clinical and Paraclinical Findings in Diabetic Patients

Peripheral neuropathy has been known as the main cause of diabetic foot ulcer and limb amputation. Early diagnosis of this complication can prevent more severe morbidity as well as enormous economic costs.

Based on the duration of the disease, 110 diabetic patients were divided in two groups of less than 10 and more than 10-year history. After taking complete history about the symptoms of neuropathy, the patients were examined neurologically. Then, electrodiagnostic studies were performed on the patients.

96 patients (87/2%) had diabetic neuropathy. The prevalence of neuropathy had a significant relationship with the duration of the disease (P value= 0.004). 61 patients (55/4%) complained of neuropathic symptoms. The results of the neurological exams were abnormal in 65 patients (59.09%). The most common symptom was paresthesia (50% of patients) and the most frequent sign was abnormal Achille's reflex. 77 patients (70%) had abnormal indices in nerve conduction studies the most common of which was decrease amplitude of peroneal and sural nerves. 16 patients (14/5%) showed alterations in NCS in the absence of clinical signs or symptoms and 19 patients (17/2%) had normal NCS indices despite the presence of signs or symptoms of neuropathy.

High sensitivity of taking history and a careful neurological examination in the diagnosis of diabetic neuropathy necessitates physicians to pay more attention to clinical examinations and patient complaints, and avoid costly electrodiagnostic investigations. Thus, early diagnosis of sub-clinical neuropathy in these patients and providing them with necessary recommendations, irreversible complications such as amputation can be prevented.