Comparing the Effectiveness of Michigan Neuropathy Screening Instrument and Neurosensory Analyzer, Electromyography in Detecting the Prevalence of Diabetic Neuropathy
Abstract Number: 413-PP
Authors: TURKAN METE, MUSTAFA SAKA, DILEK BERKER, SULE BILEN, SERHAT ISIK, GULHAN AKBABA, SERDAR GULER
Institutions: Ankara, Turkey
Results: Aim of the study was to diagnose prevalence of diabetic neuropathy and compare effectiveness of Michigan Neuropathy Screening Instrument and Neurosensory Analyser, electromyography in detecting existence of diabetic neuropathy in diabetes patients. 107 patients with diabetes mellitus was enrolled to the study. Patients with other causes of peripheral neuropathy were excluded from the study. Patients were evaluated by glycemic regulation tests (HbA1c, fasting and postprandial blood glucose levels), Michigan Neuropathy Screening Instrument (MNSI) (questionnaire and physical examination), electromyography (EMG) an neurothesiometer. Mean age of patients was 49.55±10.28 years. 43 of the patients were male. Mean duration of the diabetes was 99.48±80.96 months (0-312 month). Four of patients were newly diagnosed and having no medication during the examination period. Mean HbA1c was 8.4±2.3 (5.3-15.9). There were retinopathy in 26 patients (20 nonproliferative, 6 proliferative,) and there were nephropathy in 28 patiens. Mean MNSI scores were 6.7±2.7 and 1.4±0.6 respectively. In 54 patients, there were abnormal results in electromyography (10 sensory, 9 motor, 30 sensory motor neuropathy, 5 mononeuropathy). Also there were abnormal alterations in temperature and/or vibratory sensations in 72 of 107 patients in neurothesiometer examination (7 elevated cold and 11 elevated warm sensation thresholds, 23 elevated cold and warm sensation threshold, 6 elevated vibration sensation thresholds, 25 elevated thermal and vibration threshold). According to MNSI score, there was diabetic neuropathy in 31 patients (Score ≥2). However when patients were evaluated by EMG and neurothesiometer, we detected neurological impairments in 54 and 72 patients respectively. According to these findings, evaluating the patients only with questionnaires and physical examination may underestimate prevalence of diabetic neuropathy. As a conclusion we recommend that all diabetic patients should be evaluated by neurological testes for prevention of this underestimation and to provide early treatment options to prevent neuropathic complications.