Study of Incidence and Prevalence of Diabetic Peripheral Neuropathy in Type II Diabetes Mellitus by Bedside Screening Techniques at a Tertiary Care Centre
Keywords:
Bedside Screening, Biothesiometer, Monofilament, Peripheral Neuropathy, Tuning Fork Test, Type 2 Diabetes MellitusAbstract
Introduction: Diabetes mellitus commonly leads to peripheral neuropathy in patients with chronically high blood sugar levels. Diabetic peripheral neuropathy leads to numbness, loss of sensation or may have extremely painful symptoms. In some patients there might be marked neuropathic deficit which may be unnoticed. Objectives: Hence to evaluate patients with diabetes mellitus helps in early screening of peripheral neuropathy. Methodology: This involves using the bedside screening techniques like monofilament test, biothesiometer, tuning fork test and diabetic symptom and examination questioner. Results: Diabetic neuropathy was most commonly present in poor control of diabetes (67%) followed by fair control (24%) and good control (9%). It was observed that severity of peripheral neuropathy was related with blood sugar. With high frequency of patients leading to diabetic peripheral neuropathy the observation is that morbidity remains high in such patients. Conclusion: Diabetic peripheral neuropathy is a major complication of diabetes mellitus. Rapid diagnosis and management are important, since recent modalities include like tricyclic antidepressants or anticonvulsants and optimal glycemic control can improve outcome of these patients. Early diagnosis of diabetic peripheral neuropathy is considered at risk of foot ulcerations and must receive preventive education and care.Downloads
Published
Issue
Section
References
American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care. 2015; 38(Suppl 1):S1-S94
Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med. 2013; 368:1613-24. https://doi.
org/10.1056/NEJMsa1213829. PMid:23614587
Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: A systematic review. Prev Chronic Dis 2013; 10:E26.
https://doi.org/10.5888/pcd10.120180. PMid:23428085 PMCid:PMC3604796
Piatt GA, Anderson RM, Brooks MM, et al. 3 year follow-up of clinical and behavioral improvements following a multifaceted diabetes care intervention: Results of a randomized controlled trial. Diabetes Educ. 2010; 36:301-9. https://doi.
org/10.1177/0145721710361388. PMid:20200284
Merskey H, Bogduk N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms, 2nd ed. Seattle: IASP Press; 1994. p. 209-14.
Dyck PJ, Thomas PK. Disease of peripheral nervous system. In: Ehlers J, editor. Peripheral Neuropathy. 4 th ed.
Philadelphia: Elsevier Saunders; 1999. p. 1135-37.
Tesfaye S, Vileikyte L, Rayman G, Sindrup S, Perkins B, Baconja M, et al. On behalf of the Toronto Expert Panel on Diabetic Neuropathy. Painful diabetic peripheral neuropathy: Consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011. https://doi.org/10.1002/dmrr.1225. PMid:21695762
Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care. 2011; 34:2220-4. https://doi.org/ 10.2337/dc11-1108. PMid:21852677 PMCid:PMC3177727
Bansal V, Kalita J, Misra UK. Diabetic neuropathy.
Postgrad Med J. 2006; 82:95-100. https://doi.org/10.1136/ pgmj.2005.036137. PMid:16461471 PMCid:PMC2596705
Ashok S, Ramu M, Deepa R, Mohan V. Prevalence of neuropathy in type 2 diabetic patients attending a diabetes centre in South India. J Assoc Physicians India. 2002; 50:546-50.
Yach D, Stuckler D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nature Medicine 2006; 12(1):62-6. https://doi.
org/10.1038/nm0106-62. PMid:16397571
Creager MA, Luscher TF, Cosentino F, Beckman H.
Diabetes and vascular disease: Pathophysiology, clinical consequences, and medical therapy: Part I. Circulation.
; 108(12):1527-32. https://doi.org/10.1161/01.CIR.
32. PMid:14504252
American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 2013; 36(Suppl 1):S11-66.
https://doi.org/10.2337/dc13-S011. PMid:23264422 PMCid: PMC3537269
Boulton AJ, Gries FA, Jervell JA. Guidelines for the diagnosis and outpatient management of diabetic peripheral neuropathy. Diabetes Medicine. 1998; 15(6):508-14. https:// doi.org/10.1002/(SICI)1096-9136(199806)15:6<508::AIDDIA613>3.0.CO;2-L
Soliman E, Gellido C. Diabetic Neuropathy. eMedicine.
com; March 29, 2002. Dorsey RR, Eberhardt MS, Gregg EW, Geiss LS. Control of risk factors among people with diagnosed diabetes, by lower extremity disease status. Prev Chronic Dis. 2009 Oct. 6(4):A114.
Shaw JE, Hodge AM, deCoruten M, Dowse GK, Gareeboo H, Tuomilehto J et al.; Diabetic peripheral neuropathy in Mauritius: Prevalence and risk factors. Diabetes Res Clin Pract. 1998; 43(2):131-139. https://doi.org/10.1016/S01688227(98)00100-4
Kasturi AS, Yadhav RPS, Kurian G, Gupta MM. Cardiac autonomic neuropathy in diabetes mellitus. JAPI. 1991; 39(11):477