Validity of the Filipino Version of the Michigan Neuropathy Screening Instrument as a Measure of Distal Symmetric Peripheral Neuropathy among Diabetic Patients in the Clinic

Aims: To determine the accuracy of the Filipino version of the Michigan Neuropathy Screening Instrument (MNSI) in detecting distal symmetric peripheral neuropathy (DSPN) among diabetic patients, by comparing it to electromyography-nerve conduction velocity (EMG-NCV) as a gold standard.

Study Design: Cross-sectional study.

Place and Duration of the Study: Out-patient Department, University of the East Ramon Magsaysay Memorial Medical Center Inc., Philippines; From May 2016 to March 2017.

Methodology: Researchers tested 103 patients with Type 2 diabetes mellitus in the out-patient clinic of a single-centre tertiary hospital and determined the sensitivity and specificity of the Filipino version of the MNSI in identifying DSPN by comparing it to the EMG-NCV as a gold standard. Risk factors for neuropathy were also identified.

Results: The sensitivity of the combined Filipino MNSI questionnaire and clinical examination tool was 74.7%, and a specificity of 25%. The MNSI questionnaire scores had a statistically significant correlation to the degree of neuropathy as measured by the EMG-NCV (P= .01). There was no statistically significant difference between those with and without DSPN in terms of BMI, history of smoking, duration of diabetes, level of glycaemic control or presence of hypertension.

Conclusion: The Filipino MNSI may be used as a screening tool for distal symmetric peripheral neuropathy among diabetic patients due to its high sensitivity (74.7%). A positive Filipino MNSI will signal the need for further investigation using the EMG-NCV. The MNSI can be performed easily by a healthcare worker in the clinic to screen diabetic patients for neuropathy, and to monitor disease severity, preventing its complications.