Distal symmetrical polyneuropathy detected by vibration perception threshold among adults with and without diabetes attending a general outpatient clinic in Ilorin, Nigeria

Published: June 30, 2022
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The aim of this study is to compare the prevalence, severity, and symptoms of Distal Symmetrical Polyneuropathy (DSP) among adult patients with diabetes and those without diabetes in a primary care clinic. It was a cross-sectional comparative study involving 72 adults of between 40-60 years of age living with diabetes and 72 age-matched adults without diabetes. DSP was assessed with a biothesiometer device, and data analysis was performed using the SPSS Version 21 statistical software. The overall prevalence of neuropathy among the participants was 68.1% for those living with diabetes and 38.9% for the other group. Furthermore, 22.3% of the diabetes group had severe neuropathy compared with 8.3% of the other group. These differences were found to be statistically significant with p=0.001 (df = 2, X2 = 14.07). We reported higher prevalence and severity of DSP in those living with diabetes. We also found significant association between high VPT (≥25V) and presence of neuropathic symptoms thereby enhancing the use of the biothesiometer device in the diagnosis of adults with DSP in the primary care setting.

Doughty CY, Sadjadi R. Approach to peripheral neuropathy for primary care clinicians. Am J Med 2017;12:042

Callaghan BC, Kerber KA, Lisabeth LL et al. Role of neurologists and diagnostic tests on management of distal symmetric polyneuropathy. JAMA Neurology 2014;71:1143- 9. DOI: https://doi.org/10.1001/jamaneurol.2014.1279

Trhennsen I, Smith I, Hausager AM, et al. Evaluation of patients with symptoms suggestive of chronic polyneuropathy. J Clin Neuromusc Dis 2001;3:47-52. DOI: https://doi.org/10.1097/00131402-200112000-00001

Boulton A, Vinik A, Arezzo J, et al. Diabetic neuropathies. A statement by the American Diabetes Association. Diabetes Care 2005;28:956-62. DOI: https://doi.org/10.2337/diacare.28.4.956

Tesfaye S, Boulton AJ, Dickensen A. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013;36:2456–65. DOI: https://doi.org/10.2337/dc12-1964

Román-Pintos LM, Villegas-Rivera G, Rodríguez-Carrizalez AD, Miranda-Díaz AG, Cardona-Muñoz EG. Diabetic polyneuropathy in type 2 diabetes mellitus: Inflammation, oxidative stress, and mitochondrial function. J Diabetes Res 2016;2016:3425617. DOI: https://doi.org/10.1155/2016/3425617

Ibrahim A, Owolabi LF, Borodo MM, Ogunniyi A. Clinical profile of diabetic sensorimotor polyneuropathy in a tertiary hospital in North Western Nigeria. Niger J Basic Clin Sci 2015;12:13-9. DOI: https://doi.org/10.4103/0331-8540.156669

Owolabi MO, Ipadeola A, Adeleye JU. Aggregate cardiovascular risk is a stronger statistical correlate of clinically evident diabetic peripheral neuropathy than HbA1c alone. Nig Med J 2010;102:707-12. DOI: https://doi.org/10.1016/S0027-9684(15)30656-8

Kaoje YS, Bello F, Bankn IK, et al. Prevalence and severity of distal symmetrical polyneuropathy among patients with type 2 diabetes mellitus in Zaria, Nigeria. Diabetes Updates 2020;6:1000142. DOI: https://doi.org/10.15761/DU.1000142

Bello A, Biliaminu S, Wahab K, Sanya E. Distal symmetrical polyneuropathy and cardiovascular autonomic neuropathy among diabetic patients in Ilorin: Prevalence and predictors. Niger Postgrad Med J 2019;26:123-8. DOI: https://doi.org/10.4103/npmj.npmj_30_19

Boulton A. Managemt of diabetic peripheral neuropathy. Clin Diabetes 2005;23:9-15. DOI: https://doi.org/10.2337/diaclin.23.1.9

Vinik AI, Nevoret ML, Casellini C, Parson H. Diabetic neuropathy. Endocrinol Metab Clin North Am 2013;42:747-87. DOI: https://doi.org/10.1016/j.ecl.2013.06.001

Burns TM, Mauermann ML. The evaluation of polyneuropathies. Neurology 2011;15:S6-13. DOI: https://doi.org/10.1212/WNL.0b013e31820c3622

Oguejiofor OC, Odenigbo, UC, Oguejiofor C. Screening for peripheral neuropathy in diabetic patients: The benefits of the United Kingdom Screening Test – UKST- (a clinical scoring system). Trop J Med Res 2008;12:45–9. DOI: https://doi.org/10.4314/tjmr.v12i1.30491

Tanveer BA, Adil WH, Nahida WY, et al. Diagnostic accuracy of different bedside clinical methods in evaluation of peripheral neuropathy in patients of diabetes mellitus: Experience at a tertiary care center in North India. Int J Sci Study 2019;7:98–104.

Teunissen LL, Eurelings M, Notermans NC, et al. Quality of life in patients with axonal polyneuropathy. J Neurol 2000;247:195-9. DOI: https://doi.org/10.1007/s004150050562

Hermonwh, Kennedy L. Underdiagnosis of peripheral neuropathy in type 2 diabetes. Diabetes Care 2005:28:1480-1. DOI: https://doi.org/10.2337/diacare.28.6.1480

Young MJ, Breddy JL, Veves A BA. The prediction of diabetic neuropathic foot ulceration using vibration perception thresholds. A prospective study. Diabetes Care 1994;17:557–60. DOI: https://doi.org/10.2337/diacare.17.6.557

Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening test for peripheral neuropathy in the diabetes clinic. Diabetes Care 2001;24:250–6. DOI: https://doi.org/10.2337/diacare.24.2.250

OpenEpi: Sample size calculator for cross-sectional, cohort, and clinical Trials. Accessed on 25/10/2021. Available at: https://www.openepi.com/SampleSize/SSCohort.htm

Kody’s digital biothesiometer online manual. Accessed on 29/4/2022. Available at: https://kodymedical.com/diabetic-neuropathy-equipment/

Dash S, Thakur AK. Perception of vibration threshold is a marker of diabetic neuropathy. Natl J Physiol Pharm Pharmacol 2017;7:1003-6 DOI: https://doi.org/10.5455/njppp.2017.7.0518326052017

England JD, Gronseth GS, Franklin G, et al. Distal symmetric polyneuropathy: A definition for clinical research: Report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2005;64:199-207. DOI: https://doi.org/10.1212/01.WNL.0000149522.32823.EA

Richard JL, Reilhes L, Buvry S, et al. Screening patients at risk for diabetic foot ulceration: a comparison between measurement of vibration perception threshold and 10‐g monofilament test. Int Wound J 2014;11:147-51. DOI: https://doi.org/10.1111/j.1742-481X.2012.01051.x

Tesfaye S. Recent advances in the management of diabetic distal symmetrical polyneuropathy. JDI 2011;2:33–42. DOI: https://doi.org/10.1111/j.2040-1124.2010.00083.x

Maser RE, Steenkiste AR, Dorman JS, et al. Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes 1989;38:1456-61. DOI: https://doi.org/10.2337/diabetes.38.11.1456

Kengne AP, Sobngwi E, Echouffo-Tcheugui JB, Mbanya JC. New insights on diabetes mellitus and obesity in Africa-part 2: prevention, screening and economic burden. Heart 2013;99:1072–7. DOI: https://doi.org/10.1136/heartjnl-2013-303773

Gregg EW, Sorlie P, Paulose-Ram R, et al. Prevalence of lower-extremity disease in the US adult population >=40 years of age with and without diabetes: 1999-2000 National Health and Nutrition Examination Survey. Diabetes Care 2004;27:1591-7. DOI: https://doi.org/10.2337/diacare.27.7.1591

Barbosa AP, Medina JL, Ramos EP, Barros HP. Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese primary health care population. Diabetes Metab 2001;27:496-502.

Papanas N, Ziegler D. Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015. Rev Diabet Stud 2015;12:48-62. DOI: https://doi.org/10.1900/RDS.2015.12.48

Obalowu, Ismaila, Abdulkadir Mohammed, Christy Ademola, Ramat Yusuf, Kola Alabi, and Wemimo Alaofin. 2022. “Distal Symmetrical Polyneuropathy Detected by Vibration Perception Threshold Among Adults With and Without Diabetes Attending a General Outpatient Clinic in Ilorin, Nigeria”. Annals of African Medical Research 5 (1). https://doi.org/10.4081/aamr.2022.159.


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