Document Detail


The assessment of clinical distal symmetric polyneuropathy in type 1 diabetes: a comparison of methodologies from the Pittsburgh Epidemiology of Diabetes Complications Cohort.
MedLine Citation:
PMID:  21411172     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Distal symmetrical polyneuropathy (DSP) is the most common type of diabetic neuropathy, but often difficult to diagnose reliably. We evaluated the cross-sectional association between three point-of-care devices, Vibratron II, NC-stat(®), and Neurometer(®), and two clinical protocols, MNSI and monofilament, in identifying those with DSP, and/or amputation/ulcer/neuropathic pain (AUP), the two outcomes of major concern. This report presents data from 195 type 1 diabetic participants of the Epidemiology of Diabetes Complications (EDC) Study attending the 18-year examination (2004-2006). Participants with physician-diagnosed DSP, AUP or who were abnormal on the NC-stat, and the Vibratron II, MNSI, and monofilament were older (p<0.05) and had a longer duration of diabetes (p < 0.05). There was no difference by sex for DSP, AUP, or any testing modality, with the exception of NCstat (motor). The Vibratron II and MNSI showed the highest sensitivity for DSP (>87%) and AUP (>80%), whereas the monofilament had the highest specificity (98% DSP, 94% AUP) and positive predictive value (89% DSP, 47% AUP), but lowest sensitivity (20% DSP, 30% AUP). The MNSI also had the highest negative predictive value (83%) and Youden's Index (37%) and currently presents the single best combination of sensitivity and specificity of DSP in type 1 diabetes.
Authors:
G Pambianco; T Costacou; Elsa Strotmeyer; T J Orchard
Publication Detail:
Type:  Journal Article     Date:  2011-03-15
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  92     ISSN:  1872-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-16     Completed Date:  2011-09-30     Revised Date:  2012-05-02    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  280-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
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MeSH Terms
Descriptor/Qualifier:
Adult
Diabetes Mellitus, Type 1 / complications*
Diabetic Neuropathies / diagnosis*,  etiology
Female
Humans
Male
Middle Aged
Prospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
R37 DK034818-26/DK/NIDDK NIH HHS; R37 DK034818-28/DK/NIDDK NIH HHS

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