تعيين شيوع پلي نوروپاتي ديابتي از طريق معاينه فيزيكي و يافته هاي الكترودياكنوستيك

Determination of diabetic- polyneuropathy prevalence through clinical examination and electrodiognostic findings

Background and Aim: Polyneuropathy is one of the most common complications of type 2 diabetes mellitus. Clinical examination and electrophysiological findings (i.e., nerve conduction velocity) will not only provide an accurate diagnosis of neuropathy but will also help the physician in preventing and treating the disorder. The aim of the current study was to determine the prevalence of neuropathy as well as the validity of the clinical scoring system in detecting the presence and severity of diabetic peripheral sensorimotor polyneuropathy-as confirmed by nerve conduction velocity. Materials and Methods: In this cross-sectional study conducted at the diabetic center affiliated to Isfahan University of Medical Sciences, 446 Patients were evaluated by two neurologists and two residents. Through neurologic examination all patients were classified into four categories; namely patients with no neuropathy, mild neuropathic ones, those with moderate neuropathy, and cases suffering from severe neuropathy. A number of patients with moderate and severe neuropathy were tested for nerve conduction velocity. All of the obtained data was analyzed by SPSS using Chi-square statistical test at the significant level of P<0.0.5. Results: Sensorimotor polyneuropathy was clinically diagnosed in 77.4% of the cases, mild polyneuropathy in 47.98%, moderate neuropathy in 25.78%, and severe polyneuropathy in 3.59%. 22.65% of the subjects were not affected by neuropathy. Nerve conduction velocity was assessed in 62 patients with moderate and severe neuropathy; the results showed high correlation with the neurological scoring system (P<0.05). Conclusion: The prevalence of sensorimotor neuropathy is relatively high in our catchment area (Isfahan). Moreover, the clinical scoring system is a valid tool in early diagnosis of neuropathy in which the primary caregiver would be able to realize diabetic complications such as pain in the limbs, foot ulcer, and syncopal attack.