Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-rbzxz Total loading time: 0.235 Render date: 2022-05-23T02:09:57.374Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

Clinical Testing in Diabetic Peripheral Neuropathy

Published online by Cambridge University Press:  18 September 2015

Eva L. Feldman*
Affiliation:
Neuromuscular Section, Department of Neurology, University of Michigan, Ann Arbor
Martin J. Stevens
Affiliation:
Department of Endocrinology, University of Michigan, Ann Arbor
*
Department of Neurology, University of Michigan Medical Center, 200 Zina Pitcher Place, Room 4414 Kresge III, Ann Arbor, MI, USA 48109-0588
Rights & Permissions[Opens in a new window]

Abstract:

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Diabetic polyneuropathy is a complex disease of progressive nerve fiber loss. Initial screening and diagnosis in clinical practice usually depend on assessment of subjective complaints. A need exists for objective, simple, and reproducible assessment tools that can be readily used in clinical practice. The importance of early diagnosis is highlighted by the recent North American Diabetes Control and Complications Trial where intensive insulin therapy reduced the risk of developing diabetic neuropathy by 61%. At the University of Michigan, we have developed an outpatient neuropathy program. Patients are given a questionnaire and a brief screening examination, designated the Neuropathy Screening Instrument. Diabetic neuropathy is confirmed and staged in patients with a positive Neuropathy Screening Instrument, by a quantitative neurologic examination and nerve conduction studies, designated the Diabetic Neuropathy Score. The Michigan program has been compared with well-established instruments and has been found to be sensitive and reproducible for screening and diagnosis. We believe the program provides a valuable tool for the clinician in the practice setting and should allow diagnosis and intervention earlier in the course of diabetic neuropathy.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

References

1.Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977986.CrossRefGoogle Scholar
2.Schoenberg, BS, Melton, LJ.Epidemiologic approaches to peripheral neuropathyIn: Dyck, PJ, Thomas, PK, eds. Peripheral Neuropathy. Philadelphia, PA: W.B. Saunders Company; 1993: 775782.Google Scholar
3.Pirart, J.Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients between 1947 and 1973. Diabetes Care 1978; 1: 168–188, 252263.CrossRefGoogle Scholar
4.Dyck, PJ.Detection, characterization, and staging of polyneuropathy: assessed in diabetics. Muscle Nerve 1988; 11: 2132.CrossRefGoogle ScholarPubMed
5.Dyck, PJ, Karnes, JL, O’Brien, PC, Swanson, CJ.Neuropathy symptom profile in health, motor neuron disease, diabetic neuropathy and amyloidosis. Neurology 1986; 36: 13051308.CrossRefGoogle ScholarPubMed
6.Dyck, PJ, Sherman, WR, Hallcher, LM, et al. Human diabetic endoneurial sorbitol, fructose and myo-inositol related to sural nerve morphometry. Ann Neurol 1980; 8: 590596.CrossRefGoogle ScholarPubMed
7.Dyck, PJ, Karnes, JL, Daube, JR, O’Brien, PC, Service, FJ.Clinical and neuropathological criteria for the diagnosis and staging of diabetic polyneuropathy. Brain 1985; 108: 861880.CrossRefGoogle ScholarPubMed
8.Sima, AAF, Bril, V, Nathaniel, V, et al. Regeneration and repair of myelinated fibers in sural-nerve biopsy specimens from patients with diabetic neuropathy treated with sorbinil. N Engl J Med 1988; 319: 548555.CrossRefGoogle ScholarPubMed
9.Consensus Statement of the American Diabetes Association and the American Academy of Neurology: Report and Recommendations of the San Antonio Conference on Diabetic Neuropathy. Diabetes 1988; 37: 10001004.CrossRefGoogle Scholar
10.Dyck, PJ, Kratz, KM, Lehman, KA, et al. The Rochester Diabetic Neuropathy Study: design, criteria for types of neuropathy, selection bias, and reproducibility of neuropathic tests. Neurology 1991; 41: 799807.CrossRefGoogle ScholarPubMed
11.Feldman, EL, Stevens, MJ, Thomas, PK, et al. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care 1994; in press.Google Scholar
You have Access
67
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Clinical Testing in Diabetic Peripheral Neuropathy
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Clinical Testing in Diabetic Peripheral Neuropathy
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Clinical Testing in Diabetic Peripheral Neuropathy
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *