Analysis of assessment scales and laboratory data of diabetic polyneuropathy
Rationale: A feature of diabetes (D) type 2 is that neuropathy symptoms are often detected at the time of diagnosis. However, despite the frequency of occurrence (up to 100%) and typical symptoms, diabetic polyneuropathy (DPN) is poorly diagnosed, especially in the early stages. Therefore, the use of specialized scales and questionnaires to identify neuropathies is necessary for the timely detection of this pathology. Objective: Assess the presence and severity of DPN symptoms using modern questionnaires and compare the obtained data with clinical and laboratory indicators. Methods: Collection of history, complaints and analysis of laboratory data of 104 patients with type 2 D complicated by the development of DPN for 2018. To assess the severity of neuropathy manifestations, they used: MNSI (Michigan Neuropathy Screening Questionnaire), NSS (Neurological Symptom Scale), and TSS (General Neurological Symptom Scale). 2 groups were formed in accordance with patients' complaints. The first (main) group included 56 patients with type 2 D, which was complicated by distal symmetric senso-motor polyneuropathy and complaints associated with limb damage. In the second group (comparison group), 48 patients with type 2 D and DPN were selected, but without the above complaints. Statistical analyses were performed using the Wilcoxon and Spearman criteria. Results: Analysis of two patient subgroups revealed no significant differences by age and gender. It is noted that in the group of patients complaining of limb damage, the level of points scored on each scale is higher (MNSI questionnaire 5.8 ± 2.3 and 5.7 ± 1.7 points, MSS scale 6.2 ± 1.9 and 5.7 ± 1.9 points, respectively), but a significant difference is observed on the TSS scale (7.8 ± 2.7 and 6.9 ± 1.6, respectively, p < 0.05). In addition, the level of glycemia and cholesterolemia was also higher in the 1 group (glucose 8.1 ± 1.3 and 7.7 ± 1.7 mmol/l, cholesterol 5.2 ± 1.5 and 4.6 ± 0.9 mmol/l, respectively). When comparing the results of the questionnaires and laboratory indicators, it was revealed that there is a direct correlation between the TSS scale and the levels of glycemia and cholesterolemia (r = 1.0, p < 0.05) in the compared groups). Correlation between the NSS scale and glycemia, blood cholesterol is weak, r = - 0.14, p > 0.05. Conclusion: Application of specialized scales and questionnaires on detection of DPN is necessary for timely detection of HC lesions. To assess the severity of neuropathy, the TSS scale is most informative. The presence and severity of DPN in patients with type 2 D is associated with hyperglycemia and hypercholesterolemia, which indicates the importance and need to monitor these indicators in order to prevent the development of D complications by the NS.