Comparative study of detection of diabetic neuropathy by clinical and nerve conduction study in type 2 diabetes mellitus patients
Keywords:Clinical examination, Diabetic neuropathy, Nerve conduction study, Type 2 Diabetes mellitus
Background: Diabetes mellitus is known for its complications such as retinopathy, neuropathy and nephropathy. Diabetic neuropathy is one of the devastating complication associated with diabetes mellitus. The objective of this study was to detect sensory motor neuropathy in type 2 Diabetes mellitus by clinical examination and nerve conduction study and to correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 Diabetes mellitus.
Methods: This study was undertaken to study types of neuropathy in type 2 diabetes and to correlate clinical features of peripheral neuropathy with nerve conduction study in type 2 diabetes mellitus.100 patients with diabetes whose onset of diabetes mellitus after age of 30 years and duration of diabetes 5 years or more visiting SGRDIMSR, Vallah, Amritsar were subjected to nerve conduction study to find out peripheral neuropathy.
Results: Eight four percentage patients were found to have neuropathy on NCS whereas only 61% of patients were found to have neuropathy on clinical examination and detection rate with NCS was statistically significant (p <0.001) as compared to clinical examination.
Conclusions: NCS helps in early detection of neuropathy and most common form of diabetic neuropathy is distal symmetrical polyneuropathy.
Ozougwu JC, Obimba KC, Belonwu CD, Unakalamba CB. The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. JAPI. 2013;4(4):46-57.
Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217-30.
Cade WT. Diabetes related microvascular and macrovascular disease in physical therapy setting. Phys Ther. 2008;88(11):1322-35.
Freeman R. Not all neuropathy in diabetes is of diabetic etiology: differential diagnosis of diabetic neuropathy. Curr Diab Rep. 2009;9:423-31.
Watanabe T, Ito H, Morita A, Uno Y, Nishimura T, Kawase H, et al. Sonographic evaluation of the median nerve in diabetic patients: comparison with nerve conduction studies. J Ultrasound Med. 2009;28(6):727-34.
Asad A, Hameed MA, Khan UA, Butt MU, Ahmed N, Nadeem A. Comparison of nerve conduction studies with diabetic neuropathy symptom score and diabetic neuropathy examination score in type-2 diabetics. J Pak Med Assoc. 2009;59(9):594-8.
Edwards JL, Vincent AM, Cheng HT, Feldman EL. Diabetic neuropathy: mechanisms to management. Pharmacol Ther. 2008;120:1-34.
Gooch C, Podwall D. The diabetic neuropathies. Neurologist. 2004;10:311-22.
Partanen J, Niskanen L, Lehtinen J, Mervaala E, Siitonen O, Uusitupa M. Natural history of peripheral neuropathy in patients with non-insulin dependent diabetes mellitus. N Engl J Med. 1995;333(2):89-94.
Buse JB, Polonsky KS, Burant CF. Type 2 diabetes mellitus. In: Larsen PR, Henry M, Melmed S, Kenneth S, editors. Williams Textbook of Endocrinology. 10th Ed. Philadelphia:Saunders; 2003:1427-83.
Prasad N, Pisharody IK, Karandikar MS, Diwanji SA, Raghav PR. Comparative analysis of electrophysiological parameters of median nerve in normal and diabetic subjects. Indian Medical Gazette. 2013;147(7):261-4.
Nisar MU, Asad A, Waqas A, Ali N, Nisar A. Association of diabetic neuropathy with duration of type 2 diabetes and glycemic control. Cureus. 2015;7(8):302-6.
Kalkarni AL, Gokhale VS, Vohra KV, Chaudhary N. Clinical and nerve conduction study correlation in patients of diabetic neuropathy. JAPI. 2014;62(1):24-7.
Shehab DK, Aijarallah KF, Abraham M, Mojiminjyi OA, Mohamedy H, Abdella NA. Back to basics: ankle reflex in the evaluation of peripheral neuropathy in type 2 diabetes mellitus. QJM. 2012;105(4):315-20.
Holiner I, Haslinger V, Lutschg J, Muller G, Barbarini DS, Fussenegger J, et al. Validity of the neurological examination in diagnosing diabetic peripheral neuropathy. Pediatr Neurol. 2013;49(3):171-7.