Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study
Introduction: Diabetes is a non-communicable metabolic disorder which is associated with numerous vascular and non-vascular complications. Neuropathy is one of the most important complications which, if not recognized and treated early may result in significant disability and poor quality of li...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/10986/30598_CE(RA1)_F(T)_PF1(AG_TG_SS)_PFA(NC_MJ_GG).pdf |
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| author | D Udayashankar Sarah S Premraj K Mayilananthi Vishwanath Naragond |
| author_facet | D Udayashankar Sarah S Premraj K Mayilananthi Vishwanath Naragond |
| author_sort | D Udayashankar |
| collection | DOAJ |
| description | Introduction: Diabetes is a non-communicable metabolic
disorder which is associated with numerous vascular and
non-vascular complications. Neuropathy is one of the most
important complications which, if not recognized and treated
early may result in significant disability and poor quality of
life. In a resource poor setting like India, where diagnostic
modalities like Nerve Conduction Study (NCS) are expensive
for early diagnosis, the present study aimed to evaluate the
effectiveness of a simple bed side assessment test, the Toronto
Clinical Neuropathy Scoring (TCNS) system in diagnosing
Diabetic Peripheral Neuropathy (DPN).
Aim: The primary objective was to determine the applicability
of Toronto clinical scoring system in DPN diagnosed by NCS
in the South Indian population. The secondary objective was to
evaluate the correlation between duration of Diabetes Mellitus
(DM), HbA1C, diabetic retinopathy and neuropathy with severity
of diabetic neuropathy as determined by the TCNS.
Materials and Methods: In a prospective cross-sectional study,
conducted over a period of 12 months from June 2015 to May
2016 at a tertiary care institute in semi-urban South India, 50
diabetic patients with symptomatic neuropathy were included. All
patients were subjected to TCNS and the results were compared
with neuropathy confirmed by NCS. Categorical variables
were expressed as percentage or proportions. Comparison of
normally and abnormally distributed continuous variables were
done by independent sample t-test and Mann – Whitney U test
respectively. Categorical variables were compared using Chisquare test or Fisher’s exact test. A p-value less than 0.05 was
considered statistically significant.
Results: The presence of neuropathy by TCNS was confirmed
in all cases by NCS. Further the severity of neuropathy as
assessed by TCNS was found to correlate well with duration
of diabetes, and the presence of diabetic retinopathy and
nephropathy. Presence of foot weakness, ataxia and upper limb
symptoms also had direct correlation with severity of diabetic
neuropathy.
Conclusion: TCNS is a sensitive scoring system used to
diagnose diabetic neuropathy and can be used as an inexpensive
bedside screening tool. |
| first_indexed | 2024-12-12T14:30:23Z |
| format | Article |
| id | doaj.art-7fb7364c6d0441ecbbb79e3c3d24fbde |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-12T14:30:23Z |
| publishDate | 2017-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-7fb7364c6d0441ecbbb79e3c3d24fbde2022-12-22T00:21:32ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-12-011112OC10OC1310.7860/JCDR/2017/30598.10986Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional StudyD Udayashankar0Sarah S Premraj1K Mayilananthi2Vishwanath Naragond3Associate Professor, Department of Internal Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Kancheepuram, Tamil Nadu, India.Assistant Professor, Department of Internal Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Kancheepuram, Tamil Nadu, India.Professor, Department of Internal Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Kancheepuram, Tamil Nadu, India.Postgraduate, Department of Internal Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Kancheepuram, Tamil Nadu, India.Introduction: Diabetes is a non-communicable metabolic disorder which is associated with numerous vascular and non-vascular complications. Neuropathy is one of the most important complications which, if not recognized and treated early may result in significant disability and poor quality of life. In a resource poor setting like India, where diagnostic modalities like Nerve Conduction Study (NCS) are expensive for early diagnosis, the present study aimed to evaluate the effectiveness of a simple bed side assessment test, the Toronto Clinical Neuropathy Scoring (TCNS) system in diagnosing Diabetic Peripheral Neuropathy (DPN). Aim: The primary objective was to determine the applicability of Toronto clinical scoring system in DPN diagnosed by NCS in the South Indian population. The secondary objective was to evaluate the correlation between duration of Diabetes Mellitus (DM), HbA1C, diabetic retinopathy and neuropathy with severity of diabetic neuropathy as determined by the TCNS. Materials and Methods: In a prospective cross-sectional study, conducted over a period of 12 months from June 2015 to May 2016 at a tertiary care institute in semi-urban South India, 50 diabetic patients with symptomatic neuropathy were included. All patients were subjected to TCNS and the results were compared with neuropathy confirmed by NCS. Categorical variables were expressed as percentage or proportions. Comparison of normally and abnormally distributed continuous variables were done by independent sample t-test and Mann – Whitney U test respectively. Categorical variables were compared using Chisquare test or Fisher’s exact test. A p-value less than 0.05 was considered statistically significant. Results: The presence of neuropathy by TCNS was confirmed in all cases by NCS. Further the severity of neuropathy as assessed by TCNS was found to correlate well with duration of diabetes, and the presence of diabetic retinopathy and nephropathy. Presence of foot weakness, ataxia and upper limb symptoms also had direct correlation with severity of diabetic neuropathy. Conclusion: TCNS is a sensitive scoring system used to diagnose diabetic neuropathy and can be used as an inexpensive bedside screening tool.https://jcdr.net/articles/PDF/10986/30598_CE(RA1)_F(T)_PF1(AG_TG_SS)_PFA(NC_MJ_GG).pdfdiabetes mellitusnerve conduction studyneuropathytoronto clinical scoring system |
| spellingShingle | D Udayashankar Sarah S Premraj K Mayilananthi Vishwanath Naragond Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study Journal of Clinical and Diagnostic Research diabetes mellitus nerve conduction study neuropathy toronto clinical scoring system |
| title | Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study |
| title_full | Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study |
| title_fullStr | Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study |
| title_full_unstemmed | Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study |
| title_short | Applicability of Toronto Clinical Neuropathy Scoring and its Correlation with Diabetic Peripheral Neuropathy: A Prospective Cross-sectional Study |
| title_sort | applicability of toronto clinical neuropathy scoring and its correlation with diabetic peripheral neuropathy a prospective cross sectional study |
| topic | diabetes mellitus nerve conduction study neuropathy toronto clinical scoring system |
| url | https://jcdr.net/articles/PDF/10986/30598_CE(RA1)_F(T)_PF1(AG_TG_SS)_PFA(NC_MJ_GG).pdf |
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