Inter-trial Variation in the Sensitivity of Thermal Threshold Testing for the Diagnosis of Neuropathy in Type 2 Diabetes Mellitus.

Autor: Gaur A; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Varatharajan S; Department of General Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Taranikanti M; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., John NA; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Kalpana M; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Ganji V; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Umesh M; Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India., Katta R; Department of Physiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India.
Jazyk: angličtina
Zdroj: International journal of applied & basic medical research [Int J Appl Basic Med Res] 2024 Jul-Sep; Vol. 14 (3), pp. 182-186. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.4103/ijabmr.ijabmr_207_24
Abstrakt: Background: Thermal threshold testing (TTT) is a simple non-invasive approach for diagnosing diabetic neuropathy earlier. Conventionally the TTT is done in all four limbs and at least 6 trials are done to obtain the mean threshold, which is time consuming.
Aim: We propose to assess the validity and reliability of reduced number of trials of TTT in the lower limbs.
Materials and Methods: After obtaining ethics approval from the Institute Ethics Committee, 100 patients with type 2 Diabetes Mellitus of both gender between the ages of 35 to 65 years attending medicine OPD were recruited. Neuropathy assessment was done using Temperature threshold testing. At least 6 trials were performed for each site and the mean threshold obtained. The mean of 5 trials, 4 trials and 3 trials were noted for the comparison.
Results: On comparing hot tests of 3 trials with 6 trials had a sensitivity and specificity of 88.7% and 96.6 %. In cold threshold testing, 4 trials and 3 trials showed similar results of sensitivity of 77.8%, specificity of 98.8%. The measures of agreement between the hot trials 6 vs 5 had Kappa value of 0.953, 6vs 4 showed a Kappa value of 0.862 and 6 vs 3 showed Kappa value of 0.819.
Conclusion: Hot threshold tests of lower limb are more sensitive than cold thresholds. The 4 trial test is a reliable test and can be performed over 6 trial tests. When time is a factor, three trials are sufficient to diagnose small fibre neuropathy.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2024 International Journal of Applied and Basic Medical Research.)
Databáze: MEDLINE
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