The accuracy of 10 g monofilament use for clinical screening of diabetes peripheral neuropathy among Indian population

Abstract

Objective The purpose of this study was to test the diagnostic accuracy of the 10g monofilament to screen for diabetic peripheral neuropathy (DPN) in India. The study further assessed the effect of physical activity, footwear use, and occupation on the outcome. Methods Non-probabilistic purposive sampling was used to recruit patients with T2DM to assess the diagnostic utility of the 10 g monofilament. 160 participants were recruited divided into 4 groups. Each group consisted of 40 participants with 20 under each category described as “Physical Worker Vs Non- physical worker” (n = 40), “Barefoot Vs Footwear” (n = 40), “Use of Slipper at Home Vs No-slippers use at home” (n = 40), “Agriculture Vs Non- agriculture” (n = 40). 10 g monofilament was used to detect the presence of protective sensation towards screening of DPN against biothesiometer (Vibration Pressure Threshold). Results The area under the ROC (receiver operating characteristic) curve was 0.6 for identifying DPN using the 10 g monofilament. Physical work (p = 0.04), footwear (p = 0.04), slipper use at home (p = 0.02) and occupation (p = 0.02) impacted on the diagnostic utility of the 10g monofilament. Conclusions This study shows that the 10 g monofilament has limited accuracy for detecting DPN in the Indian population and this is further affected by occupation, socioeconomic and religious practice.

Prevalence of peripheral neuropathy, amputation, and quality of life in patients with diabetes mellitus

“…The MNSI consisted of two parts: a self-administered questionnaire regarding Diabetic Peripheral Neuropathy (DPN) symptoms and a brief physical examination of the foot. The study employed specific equipment for assessment, including a 128 Hz frequency tuning fork with a sensitivity of 72.5% and specificity of 88.7%, a clinical hammer with a sensitivity of 51.4% and specificity of 97.7%, and a 10-g SWM diabetic monofilament with a sensitivity of 69.7% and specificity of 87.9% 22 – 24 but have a limited accuracy in Indian population, further affected by occupation, socioeconomic status and religious practices 25 Figs. ( 1 , 2 , 3 ).…”