Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score

Diabet Med. 2002 Nov;19(11):962-5. doi: 10.1046/j.1464-5491.2002.00819.x.


Aims: To provide one of the diagnostic categories for distal diabetic polyneuropathy,several symptom scoring systems are available, which are often extensive and lack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) score for diagnosing distal diabetic polyneuropathy.

Methods: We compared score characteristics of the generally accepted Neuropathy Symptom Score (NSS) with the DNS score, and tested construct validity,predictive value and reproducibility with the Diabetic Neuropathy Examination score, Semmes-Weinstein monofilaments and Vibration Perception Threshold(clinical standards) in 73 patients with diabetes (24 Type 1, 49 Type 2;43 male/30 female; mean age 57 years (19-90);mean diabetes duration 15 years (1-43)).

Results: Correlation between NSS and DNS score was high (Spearman r= 0.88). Patient scores were more differentiated on the DNS score. The relation of the NSS and DNS scores, respectively, with clinical standards was good (Spearman r= 0.21-0.60). Reproducibility of the DNS score was high (Cohen weighted kappa 0.78-0.95). The DNS score was easier to perform in clinical practice.

Conclusions: The DNS is validated, fast and easy to perform, with a high predictive value when screening for diabetic polyneuropathy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetic Neuropathies / diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination / methods
  • Neurologic Examination / standards
  • Observer Variation
  • Polyneuropathies / diagnosis*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sensory Thresholds
  • Vibration