Estimation of the Severity of Diabetic Polyneuropathy Using Convenient Methods Available in Routine Clinical Practice

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  • Yamada Kanako
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Tamura Naohisa
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital Research Support Center, Shizuoka General Hospital
  • Hatakeyama Hiroshi
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Kim Gan
    Department of Neurology, Shizuoka General Hospital
  • Kyo Chika
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Kosugi Rieko
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Ogawa Tatsuo
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Kotani Masato
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital
  • Inoue Tatsuhide
    Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital

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  • 日常臨床で使用可能な簡易検査による糖尿病多発神経障害重症度（馬場分類）の推定

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<p>A nerve conduction study (NCS) is essential for the definitive diagnosis of diabetic polyneuropathy (DPN). Baba's diabetic neuropathy classification (BDC) is an NCS-based severity classification of DPN. Although the frequency of diabetic foot and macroangiopathy is reportedly increased in patients with DPN of grade ≥2 BDC (BDC-2+), NCS has low availability. We investigated the BDC-2+detection performances of the coefficient of variation of R-R intervals and the number of positive features among sensory symptoms, diminished or absent Achilles tendon reflexes, and diminished vibration sensation, with a receiver operating characteristic analysis in 139 patients with type 2 diabetes mellitus. However, we were unable to determine useful judgement criteria. Point-of-care testing NCS on sural nerves performed in 108 patients suggested that the criteria of a compound sensory nerve action potential ≤6.5 μV and a sensory conduction velocity ≤48 m/s were able to detect BDC-2+with 100 % sensitivity and 85.7 % specificity.</p>

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