Document Detail


Diagnosis of diabetic neuropathy using simple somatic and a new autonomic (neuropad) tests in the clinical practice.
MedLine Citation:
PMID:  20200815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The global spread of diabetes (DM) and the importance of early therapeutic intervention determine the need of simple, inexpensive and sensitive methods for diagnosis of diabetic complications in the general practice. The aim of this study was to assess a new instrument - the plaster Neuropad in diagnosing the sudomotor diabetic dysfunction and to investigate the correlates of Neuropad data with diabetic complications. PATIENTS AND METHODS: In this cross-sectional study participated 264 inpatients (M/F=126/138) with DM type 1/2 (61/203), mean age 55.4+/-12.0 and DM duration of 9.3+/-7.1 years. According to hospital records were registered: anthropometric data; fasting plasma glucose and HbA1c; presence of micro-(retino-, nephro-, neuropathy), and macrovascular (arterial hypertension, coronary artery disease and/or brain vascular disease) complications, and neuropathic symptoms were evaluated. For investigation of somatic DN a modified Neuropathy Disability Score (NDS) and for sudomotor autonomic DN - Neuropad were used. RESULTS: Neuropad showed the highest between-feet correlation of 0.91 compared to all other individual tests and the NDS. Neuropad was able to separate patients in groups with different general risk profile, including age, duration of DM, presence of coronary and/or brain vascular disease, nephropathy, and retinopathy. Moreover, Neuropad differentiated patient groups by their stage of DN, evaluated by symptoms, diagnosis, the individual somatic tests and with the highest significance - by NDS. Most sensitive for detecting DN was NDS > or = 3, followed by Achilles reflexes, vibration perception (128 Hz tuning fork) and Neuropad. A borderline or abnormal result of Neuropad showed sensitivity=76.3/79.3, specificity=56.1/42.9, positive=86.3/62.8 and negative=39.5/63.0 predictive values, and diagnostic accuracy 72.2/62.9%, compared to the indices for presence of somatic DN (NDS > or = 3)/foot at risk (NDS > or = 6) respectively. CONCLUSIONS: Screening for DN must cover somatic and autonomic disturbances. Neuropad is a new sensitive and appropriate for everyday clinical use test for detecting sudomotor DN and identification of patients at higher risk for chronic diabetes complications.
Authors:
Z A Kamenov; J J Petrova; V G Christov
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Publication Detail:
Type:  Journal Article     Date:  2010-03-03
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  118     ISSN:  1439-3646     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-14     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  226-33     Citation Subset:  IM    
Copyright Information:
(c) J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart. New York.
Affiliation:
Clinic of Neurology, Alexandrovska University Hospital, Medical University - Sofia, Bulgaria. zkamenov@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Autonomic Nervous System / physiopathology
Databases, Factual
Diabetic Neuropathies / diagnosis*,  physiopathology
Female
Humans
Male
Middle Aged
Neurologic Examination / methods*
Patient Selection
Reflex / physiology
Sensory Thresholds / physiology*
Touch Perception / physiology
Vibration

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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