Polyneuropathy in Australian outpatients with type II diabetes mellitus

de Wytt, Carolyn N., Jackson, Richard V., Hockings, Gregory I., Joyner, Julie M. and Strakosch, Christopher R. (1999) Polyneuropathy in Australian outpatients with type II diabetes mellitus. Journal of Diabetes and Its Complications, 13 2: 74-78. doi:10.1016/S1056-8727(98)00028-2

Author de Wytt, Carolyn N.
Jackson, Richard V.
Hockings, Gregory I.
Joyner, Julie M.
Strakosch, Christopher R.
Title Polyneuropathy in Australian outpatients with type II diabetes mellitus
Journal name Journal of Diabetes and Its Complications   Check publisher's open access policy
ISSN 1056-8727
Publication date 1999-03
Sub-type Article (original research)
DOI 10.1016/S1056-8727(98)00028-2
Volume 13
Issue 2
Start page 74
End page 78
Total pages 5
Place of publication New York
Publisher Elsevier Science
Collection year 1999
Language eng
Subject C1
321004 Endocrinology
730105 Endocrine organs and diseases (incl. diabetes)
Abstract In order to determine the local prevalence of polyneuropathy among adult outpatients with type II (non-insulin-dependent) diabetes mellitus, we applied a series of standardised measures to patients attending a multidisciplinary diabetes clinic. The study group comprised 94 men and 15 women; mean age, 70.6 +/- 7.8 years; mean duration of diabetes, 11.7 +/- 10.1 years; and mean HbA(1C), 8.3% +/- 1.7%. Neuropathy Symptom Scores greater than or equal to 1 were present in 97% of patients (mean, 3 +/- 2; range, 0-12), and 95% had Neuropathy Disability Scores greater than or equal to 2 (mean, 27 +/- 19; range, 0-87). 52% of men reported impotence. Autonomic dysfunction on cardiovascular reflex testing was present in 46% of patients (39/84). Finger and toe vibration perception thresholds were greater than 3SD higher than mean thresholds measured in control subjects without diabetes in 43% and 58% of patients, respectively Polyneuropathy, defined as lower limb sensory and motor nerve conduction velocity or latency outside mean +/- 2SD of that measured in age-matched controls, was present in 49% of patients (53/109). These results suggest that there is a high prevalence of polyneuropathy in Australian out-patients with type II diabetes mellitus, In this study, clinical assessment using Neuropathy Disability Stores was not diagnostically useful since only five patients had a normal score. Using nerve-conduction studies as the gold standard diagnostic criteria the best alternative test for the presence of polyneuropathy was toe vibration perception threshold (sensitivity 74%, specificity 56%). In view of the emerging evidence that intensive glycaemic control reduces the rate of progression of polyneuropathy, we recommend that patients with type II diabetes mellitus have nerve-conduction studies performed for early detection of this important complication. (C) 1999 Elsevier Science Inc.
Keyword Endocrinology & Metabolism
Autonomic Neuropathy
Peripheral Neuropathy
Foot Ulceration
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 12 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 10 Jun 2008, 13:26:48 EST