The Role of a Timely Diagnosis and Full Investigation for Assessment of Subclinical Diabetic Neuropathy

Abstract

Diabetic neuropathy (DN) is a condition that causes the appearance of progressive ischemic dermal lesions in the lower extremities, leading to necrosis and, eventually, amputations, which increases morbidity and mortality in diabetic patients. Currently, there is no simple diagnostic test for diabetic neuropathy; its identification is based on the subjective interpretation of specific neuropathic symptoms and signs. In response to the need for a systematized instrument to facilitate the diagnosis of diabetic neuropathy, a specific screening and staging program has been developed at the University of Michigan. In contrast, in group II, 5 patients did not present neuropathy, 5 were in minimal stage, 9 in moderate stage and 0 in severe stage. The analysis did not reveal significant differences regarding sensitivity; however, differences were observed in relation to muscle strength and reflexes. A significant correlation was established between neuropathic affection and the duration of M.N.I.D. only in patients with clinical neuropathy. In conclusion, the M.D.N.S. study is effective in identifying evident neuropathic alterations, even in asymptomatic patients; Its implementation is accessible and can be carried out by primary care physicians, which entails a favorable cost-benefit ratio for both the patient and the health institution.