Frequency of Diabetic Polyneuropathy (DPN) and Clinical Significance of Achilles Tendon Reflex in Diagnosis of DPN-Survey of 15,000 Patients in Tohoku, Japan-

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  • Satoh Jo
    Department of Diabetes and Metabolism, Iwate Medical University Hospital/Tohoku Diabetic Complication Forum Project
  • Baba Masayuki
    Department of Neurology, Aomori Prefectural Central Hospital/Tohoku Diabetic Complication Forum Project
  • Yagihashi Soroku
    Department of Molecular Pathology, Hirosaki University/Tohoku Diabetic Complication Forum Project
  • Suda Toshihiro
    Department of Endocrinology, Metabolism, and Infectious diseases, Hirosaki University Hospital/Tohoku Diabetic Complication Forum Project
  • Tominaga Makoto
    Department of Laboratory Medicine, Yamagata University School of Medicine/Tohoku Diabetic Complication Forum Project
  • Daimon Makoto
    Third Department of Internal Medicine, Yamagata University Hospital/Tohoku Diabetic Complication Forum Project
  • Watanabe Tsuyoshi
    Third Department of Internal Medicine, Fukushima Medical University/Tohoku Diabetic Complication Forum Project
  • Oka Yoshitomo
    Department of Diabetes and Metabolism, Tohoku University Hospital/Tohoku Diabetic Complication Forum Project
  • Toyota Takayoshi
    Tohoku Rosai Hospital/Tohoku Diabetic Complication Forum Project

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Other Title
  • 糖尿病神経障害の発症頻度と臨床診断におけるアキレス腱反射の意義―東北地方１５，０００人の実態調査―
  • トウニョウビョウ シンケイ ショウガイ ノ ハッショウ ヒンド ト リンショウ シンダン ニ オケル アキレスケン ハンシャ ノ イギ トウホク チホウ 15 000ニン ノ ジッタイ チョウサ
  • -Survey of 15,000 Patients in Tohoku, Japan-
  • —東北地方15,000人の実態調査—

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To determine the epidemiological status of diabetic polyneuropathy (DPN) and the usefulness of Achilles tendon reflex (ATR) in clinical DPN diagnosis, we clinically surveyed DPN in patients with diabetes mellitus, working with 448 clinics and hospitals in Tohoku, northeastern Japan. The survey consisted of questionnaires on subjective DPN symptoms and ATR examination and vibration perception.<br>Data came from 14,744 patients with diabetes mellitus aged 64.2±11.9 years [mean±SD], with a diabetes duration of 9.7±7.7 years, and HbA1c 7.4±2.5%. The frequency of DPN symptoms was 18.8%, the absence or decrease in ATR 40.3%, and the decrease in vibration perception threshold 52.0%. The frequency of DPN was 27.6% based on the general decision of the physician in charge and 35.8% based on simplified diagnostic criteria of the Japanese Study Group on Diabetic Neuropathy, consisting of subjective symptoms of DPN, a decrease in ATR, and decreased threshold of vibration perception. ATR disappeared earlier than the appearance of subjective symptoms of DPN after diabetes onset. The frequency of loss of ATR was significantly higher in patients with subjective symptoms of DPN than in those without symptoms.<br>These results indicate a high frequency of DPN and the significance and usefulness of ATR, a simple and easy examination, in diagnosing DPN.

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