Screening of Distal Symmetric Polyneuropathy in Hospitalized Diabetic Patients
DOI:
https://doi.org/10.24950/rspmi/O/176/19/4/2019Keywords:
Diabetes Mellitus, Diabetic Neuropathies, Hospitalization, PolyneuropathiesAbstract
Introduction: Distal symmetric polyneuropathy (DSPN) is
a frequent, catastrophic and underdiagnosed complication of
diabetes mellitus. The authors have hypothesized that hospitalization could be an opportunity to screen DSPN and also
pretend to compare two different diagnostic methods.
Material and Methods: This was a prospective and multicentre study that enrolled diabetic patients admitted consecutively to internal medicine wards, between May and October
2015. Patients were evaluated using the MNSI (Michigan
Neuropathy Screening Instrument) and the SWME (10 gSemmes-Weinstein monofilament examination). A score > 2
in the clinical examination of MNSI or ≤ 7 positive answers in
a total of 10 in SWME were considered diagnostic of DSPN.
Results: Eighty-eight patients were included; average age
was 77 (13) years and 45% were males; most were type 2 diabetic patients, 7% had a previous diagnosis of DSPN. DSPN
prevalence was 75% using MNSI, SWME was abnormal in 38%
of these patients. The agreement rate between MNSI and SWME
was 44.3%. A percentage of 92.4% of the patients with a diagnosis of DSPN in the study did not have a previous diagnose.
Discussion: The number of underdiagnosed cases in this
study is alarming but had been previously detected in studies
regarding outpatient; it might represent a problem of registry
or an omission in the screening of neuropathy.
Conclusion: We have concluded that DSPN is a high
prevalent disease in hospitalized patients in Portugal, which
remains underdiagnosed. MNSI can be a good instrument to
screen neuropathy and SWME should not be used exclusively
for this purpose.
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