Screening of Sensory Peripheral Neuropathy in Type II Diabetes

Background and The newly updated American Diabetes Association guidelines based on evidence-based medical practice have proposed screening of the patients for neuropathy at the time of diagnosis with type II diabetes mellitus. However, the complex and extensive clinical manifestation of diabetic peripheral neuropathy and lack of objective evaluation indexes makes this screening rather troublesome. The goal of this study was screening of sensory peripheral neuropathy in type II diabetic patients in Ahvaz, Iran. Our study population consisted of 150 patients treated for diabetes mellitus in the Clinic of Diabetes at the Ahvaz Jundishapur University of Medical Sciences. Non-randomized sampling method was used to select the participants. All patients were tested for sensory neuropathy using two different modalities of testing: 8 and 10 gram Semmes-Weinstein Monofilaments Examinations. In next phase nerve conduction velocity was examined. Then, sensitivity and specificity of 8 and 10 gram Semmes-Weinstein Monofilaments were analyzed. Gram Semmes-Weinstein Monofilament had a sensitivity ranging from 30.8% to 64.1% at sites 1-10 while its specificity ranged from 64% to 89.2%. The sensitivity and specificity of 8 gram Semmes-Weinstein Monofilament were 28.2 to 64.1% and 62.2% to 88.3%, respectively. Semmes-Weinstein Monofilament is believed to be the best choice for clinical screening that has a good predictive ability for the risk of ulceration and amputation among people with diabetes.