Michigan Neuropathy Screening Instrument: A tool for diabetic peripheral neuropathy diagnosis in a rural area in Ecuador.
Daniella Bustamante1, Kiara Velez 2, Jorge Torres2
1Instituto Ecuatoriano de Seguridad Social, 2UCSG
Objective:
This study aims to evaluate the usefulness of the Michigan Neuropathy Screening Instrument in diabetic patients in a primary care center in a rural area of Ecuador.
Background:
Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM).Its devastating consequences such as chronic pain, foot ulcers, and limb amputation require early detection and management to reduce complications associated with the disease. The MNSI is a screening tool for DPN that includes two assessments: Part A, a questionnaire done by the patient and Part B, the inspection and assessment of vibratory sensation and ankle reflexes provided by the physician.
Design/Methods:
This is an observational and cross-sectional study. We included all diabetic patients that attended to our primary care center that is located in a rural area of Jipijapa, Ecuador from January to October 2022 and that had updated blood work. Data was analyzed using SPSS v. 25.
Results:
Out of the 30 patients that were included in the study, 53.3% were females and 46.7% were males. The mean age of the population was 65 years. 26.7% were illiterate patients, 63.3% were low-literacy and 10% were middle-educated patients. A total of 22 patients tested positive for DPN in part B MSNI, but only 6 were positive for part A. This might be attributed to the low-literacy in our study population. The Michigan part A median score was 6 SD± 2 and the part B median score was 4.1 SD± 1.9. Patients who had DPN according to MNSI part B had a median glucose of 217 mg/dl. MNSI part B showed a positive relationship with creatinine levels (p= 0.021).
Conclusions:
MNSI can be used as a screening tool for DNP in limited-resourced settings where only clinical assessment is possible.