Introduction: The simple diagnostic criteria (SDC) proposed by Diabetic Neuropathy Study Group in Japan has been widely accepted in our country. However, the diagnostic ability has not yet been fully validated. In the present study, we examined the usefulness of SDC in diagnosis of diabetic polyneuropathy (DPN).
Methods: We evaluated admitted 114 diabetic subjects who were diagnosed as DPN employing three independent decision rules consisting SDC: physical signs and symptoms (PHY), nerve conduction study (NCS), or coefficient of variation of RR interval (CVR-R) on electrocardiogram (CVRR).
#1. PHY rule: satisfied any two or more of following three items: the presence of symptoms considered to be due to DPN, the decrease or disappearance of bilateral Achilles tendon reflexes, and decreased vibration in the bilateral medial malleoli.
#2. NCS rule: one or more nerve conduction abnormalities in two or more nerves out of 12 peripheral nerves.
#3. CVRR rule: less than 2% of CVR-R.
The diagnostic accuracy was evaluated using the NCS rule as the reference standard.
1. Ninety-six subjects (84.2%) diagnosed as DPN. The proportions of DPN were 37.7% for PHY, 74.6% for NCS, and 43.9% for CVRR.
2. The diagnostic accuracy of PHY and/or CVRR.
Discussion: Diagnosis by NCS showed the highest prevalence. The sensitivity of PHY was improved by a combination with CVRR. DPN can be identified effectively utilizing SDC.
T. Himeno: None. Y. Shibata: None. H. Shimoda: None. M. Kondo: None. S. Tsunekawa: None. Y. Kato: Speaker's Bureau; Self; Merck & Co., Inc. J. Nakamura: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Japan Tobacco Inc., Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Kowa Pharmaceu. Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. H. Kamiya: Speaker's Bureau; Self; Astellas Pharma Inc., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Novo Nordisk Oharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K.