EFFICIENCY OF MICHIGAN NEUROPATHY SCREENING INSTRUMENT AND NERVE CONDUCTION STUDIES FOR DIAGNOSIS OF DIABETIC DISTAL SYMMETRIC POLYNEUROPATHY

Abstract

Background and Aims: Little data regarding distal symmetric polyneuropathy (DSP) prevalence in Romania is available. The aim of the present study was to assess the prevalence of DSP in our cohort, to characterize it depending on glycemic control, and also to find an easy-to-apply method for DSP screening which could be used in Romania. Material and Methods: We performed a cross-sectional study enrolling 51 patients followed in the Diabetes, Nutrition and Metabolic Diseases Clinic, Clinical County Hospital of Craiova, Romania. A complete evaluation protocol consisting in clinical examination and Michigan Neuropathy Screening Instrument (MNSI), together with nerve conduction studies were applied for evaluation. Results: Among the type 2 diabetic patients investigated, 72.54% had DSP. Three-quarters of them had poor glycemic control (HbA1c ≥7%). Mean HbA1c level was 9.17%. Poor glycemic control led to a more severe DSP form as proven by nerve conduction studies and clinical examination. Allodynia and motor deficit were predominantly found with HbA1c ≥7%. Mean MNSI score for the group was 2.55, strongly correlated with nerve conduction studies. Conclusion: MNSI is a simple and validated diagnostic tool for DSP with a strong correlation to electrophysiological parameters. Therefore, its daily implementation in clinical practice could help identify and follow patients at risk for DSP.