(61) Effective Screening Tool of Diabetic Peripheral Neuropathy among Adults in Type 2 Diabetes: A Scoping Review

Mr. Ricky AHAMT¹, Prof. Benny Ying-Zee CHUNG¹, Prof. Gladys Ying-Cheing LAI^2
1The Chinese University of Hong Kong, Hong Kong SAR, ²Hong Kong Polytechnic University, Hong Kong SAR

Background/Purpose
Diabetic Peripheral Neuropathy (DPN) is the most common diabetic complication for diabetic clients, and the leading cause for disability due to foot ulceration and amputation, gait disturbance, and fall related injury. Nerve Conduction Study (NCS) is regarded as gold standard in the diagnosis of DPN, but it is time consumption, inconvenience and expensive. It is important to identify a reliable tool to facilitate the screening of DPN for the large diabetic population. The current review aims to explore the existing clinical assessment in identifying adults with DPN.

Method
This review includes studies published in English, through the literature search using Ovid Medline, Pubmed and EMBase (January 2010 to June 2020), which examine diabetic peripheral neuropathy for adults with type 2 diabetes. Keywords including ‘diabetic neuropathy’, ‘diabetes’ and ‘neuropathy’, ‘screening tool’ and ‘nursing assessment’ were used in the searching process.

Results
108 studies were identified in the searching process and ten articles were included in the full review process.  Several types of methods were used to detect DPN. Quantitative sensory test, such as Monofilament test, was used to test a single point of pressure. Physical examination scoring systems, such as Michigan Neuropathy Scoring Instruments, Neuropathy symptom and Change Score and Neuropathy Impairment Score, identified patients with DPN by combining subjective symptoms expressions and physical examination. Innovative approach, such as Point of Care Devices or mobile app, examined underlying pathophysiology of the patients. Different screening tools demonstrated its strength and uniqueness, but none of all can be encouraged in the clinical use based on currently available evidence.

Conclusion
Early detection of DPN is important to prevent foot ulceration and amputation. While no single instrument has been recommended to confirm the prevalence of DPN problem, future studies are required to explore a valid and reliable test for diagnosing DPN in clinical practice.

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