A Comparison of Screening Tools for the Early Detection of Peripheral Neuropathy in Adults with and without Type 2 Diabetes

J Diabetes Res. 2017;2017:1467213. doi: 10.1155/2017/1467213. Epub 2017 Nov 8.

Abstract

Objective: Examine the effectiveness of the 128 Hz tuning fork, two monofilaments, and Norfolk Quality of Life Diabetic Neuropathy (QOL-DN) questionnaire as tools for the early detection of diabetic peripheral neuropathy (DPN) in overweight, obese, and inactive (OOI) adults or those who have prediabetes (PD) or type 2 diabetes (T2D).

Research design and methods: Thirty-four adults (mean age 58.4 years ± 12.1) were divided by glycemia (10 OOI normoglycemic, 13 PD, and 11 T2D). Sural nerves were tested bilaterally with the NC-stat DPNCheck to determine sural nerve amplitude potential (SNAP) and sural nerve conduction velocity (SNCV). All other testing results were compared to SNAP and SNCV.

Results: Total 1 g monofilament scores significantly correlated with SNAP values and yielded the highest sensitivity and specificity combinations of tested measures. Total QOL-DN scores negatively correlated with SNAP values, as did QOL-DN symptoms. QOL-DN activities of daily living correlated with the right SNAP, and the QOL-DN small fiber subscore correlated with SNCV.

Conclusions: The 1 g monofilament and total QOL-DN are effective, low-cost tools for the early detection of DPN in OOI, PD, and T2D adults. The 128 Hz tuning fork and 10 g monofilament may assist DPN screening as a tandem, but not primary, early DPN detection screening tools.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / physiopathology
  • Diagnostic Techniques, Endocrine*
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction / physiology
  • Obesity / complications
  • Obesity / physiopathology
  • Overweight / complications
  • Overweight / physiopathology
  • Sedentary Behavior
  • Sensitivity and Specificity
  • Sural Nerve / physiopathology
  • Surveys and Questionnaires