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The Semmes-Weinstein monofilament examination as a single effective screening tool in diagnosing diabetic peripheral neuropathy when compared to vibration perception threshold

Babitha R, Subathra TA.




Abstract

Background: Diabetic peripheral neuropathy (DPN) leads to foot ulcers and non-traumatic amputation, which is a major cause for morbidity and disability in India. At present, no precise pharmacological agent has confirmed efficacy in preventing disease progression or reversing neuropathy symptoms. Clinically, it is crucial to find an effective screening tool for diagnosing DPN. Although vibration perception threshold (VPT) testing and Semmes-Weinstein monofilament examination (SWME) are considered as combined diagnostic tools to diagnose DPN, a single effective screening method to identify DPN is quite unavailable in India.

Aim and Objective: This study aimed to evaluate the usefulness of the SWME in DPN when compared to VPT.

Materials and Methods: Fifty control subjects and 50 DPN subjects aged between 30 and 70 years were included in the study. The anthropometric parameters, fasting blood sugar (FBS), duration of diabetes mellitus, VPT, and the SWME were recorded.

Results: There was a significant difference in body mass index, FBS, VPT, and SWME in DPN subjects (P < 0.0001) when compared with control subjects. The increased duration of DPN increases the VPT (0.805) values and decreases the SWME (−0.488) values. In the kappa test, the measure of agreement between SWME and VPT was significant (0.960), meaning both tests are equally effective in screening DPN subjects.

Conclusion: The present findings show that SWME can be used as a single effective screening tool in diagnosing DPN when compared with VPT. This can reduce the risk of ulceration and lower extremity amputation in DPN subjects at the earliest.

Key words: Diabetic Peripheral Neuropathy; Semmes-Weinstein Monofilament Examination; Vibration Perception Threshold






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