Simple Screening Tests for Peripheral Neuropathy as a Prediction of Diabetic Foot Ulceration

Background and Objectives: Diabetes mellitus is one of the major health problems, and one of its commonest complications is peripheral neuropathy. The aim of this study is to evaluate four standard simple screening tests (10-g Semmes-Weinstein monofilament examination {SWME}, vibration sensation by a 128Hz tuning fork, superficial pain test and ankle reflex) for detection of neuropathy using the nerve conduction study ( NCSs) as the standard criterion in diabetic patients. Methods: The study included 120 patients with diabetes mellitus, all patients had complete clinical assessment including presence or absence of neuropathy, exclusion of other causes of neuropathy, NCS,10 g Semmes-Weinstein monofilament examination, vibration sensation by a 128 Hz tuning fork ,superficial pain sensation and ankle reflex were done for all patients. Results: Foot care practices were followed by 80 (66.6%) of the study population. When compared with NCSs, the monofilament was the most specific at 91%, less sensitive 57%, superficial pain, ankle reflex had lower specificity (36%, 41%) respectively, sensitivity (62%,57%) respectively. Tuning fork had specificity 90%, sensitivity 56%. Conclusion: The study findings show that the simple screening tests (10-g SWME, vibration testing ,superficial pain test and ankle reflex) can be used confidently for annual screening of diabetic neuropathy in diabetic patients.