Diabetic Peripheral Neuropathy: A Cross sectional study on the Correlation between Clinical and Electrophysiology Findings

BACKGROUND: Diabetes has emerged as an important cause of morbidity among the Indian population. Diabetic neuropathy is defined as “the presence of symptoms and signs of peripheral nerve dysfunction in individuals with diabetes mellitus after the exclusion of other causes”. This study aims to clinical symptomatology and signs of peripheral neuropathy correlate clinical and electrophysiological findings among patients with Type 2 diabetes. OBJECTIVES: 1. To study the prevalence of peripheral neuropathy in type 2 diabetes mellitus less than 5 years. 2. To study the clinical symptomatology of peripheral neuropathy in diabetic patients. 3. To study the signs of peripheral neuropathy using neuropathy symptom Score (NSS) and neuropathy disability score (NDS) in diabetic patients. 4. To correlate them with risk factors. 5. To correlate clinical features and findings on nerve conduction studies. MATERIALS AND METHODS: The study was a cross-sectional study conducted among 90 patients- Type 2 diabetic patients admitted in general medicine ward and those referred to Neurology OP clinic with symptoms and signs suggestive of peripheral neuropathy at a Tertiary care Hospital in Chennai. The study was conducted between May 2019 and April 2020.Patients were subjected to clinical evaluation-detailed history with screening for neuropathic symptoms, bedside autonomic function tests, glycemic status, blood pressure assessment Nerve Conduction study, Neuropathy severity scale and Neuropathy Disability Score. RESULTS: It was found that peripheral neuropathy had a statistically significant association with fasting blood sugar, postprandial blood sugar, HbA1c, nerve conduction study findings, serum creatinine and eGFR. In present study we found a high prevalence of peripheral neuropathy of 68.75 % in newly diagnosed type 2 Diabetes mellitus based on NSS/NDS/NCS. Neuropathy was confirmed by NCS in 55% of the patients. Among patients enrolled in present study, 68.75 % had Possible DSPN, 52.5% had Probable DSPN, and 53.75 % had confirmed DSPN and only 3.75% had subclinical DSPN. CONCLUSION: Patients with type 2DM have a high prevalence of peripheral neuropathy at diagnosis and very few of them harbor subclinical neuropathy. This study has shown that clinical examination still remains the main tool for detection of neuropathy