Validation of the Filipino-Translated Version of the Michigan Neuropathy Screening Instrument among Filipino Patients with Diabetes Mellitus Seen at the Philippine General Hospital

Authors

  • Daryl Jade Dagang Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital
  • Jose Danilo Diestro Section of Neurology, Department of Neurosciences, Philippine General Hospital http://orcid.org/0000-0001-8450-2021
  • Geohana Hamoy-Jimenez Section of Neurology, Department of Neurosciences, Philippine General Hospital
  • Iris Thiele Isip-Tan Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital http://orcid.org/0000-0003-3227-632X
  • Jose Paciano Baltazar Reyes Section of Neurology, Department of Neurosciences, Philippine General Hospital

Keywords:

diabetic neuropathy, questionnaire, Filipino, diabetes mellitus

Abstract

Objectives. To assess the validity of the Filipino-translated version of the Michigan Neuropathy Screening Instrument(MNSI) in screening for diabetic neuropathy among Filipino patients with diabetes mellitus using nerve conduction velocity(NCV) as gold standard and to determine the most accurate cut-off score for the diagnosis of neuropathy using MNSI.

Methodology. A cross-sectional analytic study was done among adult diabetic patients. The original MNSI Questionnaire was translated and back-translated to the Filipino language. Each patient answered the Filipino version of MNSI Questionnaire followed by a lower extremity examination done by the investigator. All patients underwent NCV as reference standard. Sensitivity and specificity of MNSI were determined.

Results. We studied a total of 150 subjects. Eighty-seven (58%) were diagnosed to have diabetic neuropathy based on NCV. The sensitivity and specificity of the MNSI Questionnaire improved to 73.6% and 52.4% respectively when the cut off was reduced to ≥4, whereas for the MNSI Examination, the sensitivity and specificity improved to 86.2% and 55.6% respectively when the cut off was reduced to ≥1. Combining both MNSI Questionnaire and MNSI Examination further improves the sensitivity to 95.4% whereas specificity is at 39.7%.

Conclusion. The analyses in 150 subjects confirm that the Filipino-version of MNSI is a valid screening tool for diabetic neuropathy when compared with NCV as gold standard.

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Author Biography

Daryl Jade Dagang, Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital

Fellow-in-training, Section of Endocrinology, Diabetes and Metabolism, Department of Medicine

References

Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort. Neurology. 1993;43(4):817-24. https://doi.org/10.1212/WNL.43.4.817.

United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet. 1998;352(9131):837-53. https://doi.org/10.1016/S0140-6736(98)07019-6.

Mulder DW, Lambert EH, Bastron JA, Sprague RG. The neuropathies associated with diabetes mellitus: A clinical and electromyographic study of 103 unselected diabetic patients. Neurology, 1961;11(4)Pt 1:275-84. PMID: 13773672.

Gires Arnold, et al. Severity and staging of diabetic polyneuropathy. Textbook of Diabetic Neuropathy. 2003;170-75. https://doi.org/ 10.1055/b-0034-83069.

American Diabetes Association. Report and recommendations of the San Antonio Conference on Diabetic Neuropathy. Diabetes Care. 1988;11(7):592-7. https://doi.org/10.2337/diacare.11.7.592.

Diabetic polyneuropathy in controlled clinical trials: Consensus report of the peripheral nerve society. Ann Neurol. 1995;38(3):478-82. https://doi.org/10.1002/ana.410380323.

Dyck PJ, Norell JE, Tritschler H, et al. Challenges in design of multicenter trials: End points assessed longitudinally for change and monotonicity. Diabetes Care. 2007;30(10):2619-25. https://doi.org/ 10.2337/dc06-2479.

Perkins BA, Grewal J, Ng E,Ngo M, Bril V. Validation of a novel point-of-care nerve conduction device for the detection of diabetic sensorimotor polyneuropathy. Diabetes Care. 2006;29(9):2023-7. https://doi.org/10.2337/dc08-0500.

Boulton AJM, Malik RA, Arezzo JC, Sosenko JM. Diabetic somatic neuropathies. Diabetes Care. 2004;27(6):1458-87. https://doi.org/ 10.2337/diacare.27.6.1458.

Dyck PJ, Melton III J, O’Brien PC, Service FJ. Approaches to improve epidemiological studies of diabetic neuropathy: Insights from the Rochester diabetic neuropathy study. Diabetes. 1997;46(Suppl 2):S5-8. https://doi.org/10.2337/diab.46.2.S5.

Vileikyte L, Peyrot M, Bundy C, et al. The development and validation of a neuropathy- and foot ulcer- specific quality of life instrument. Diabetes Care. 2003;26(9):2549- 55. https://doi.org/ 10.2337/diacare.26.9.2549

Vileikyte L, Rubin R, Leventhal H. Psychological aspects of diabetic neuropathic foot complications: An overview. Diabetes Metab Res Rev. 2004; 20(Suppl S1): S13–8. https://doi.org/10.1002/dmrr.437.

Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N, Greene DA. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care. 1996;17(11):1281-89. https://doi.org/10.2337/diacare.17.11.1281.14.

Herman WH, Pop-Busui R, Braffett BH, Martin CL, et.al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: Results from the diabetes control and complications trial/epidemiology of diabetes interventions and complications. Diabet Med. 2012;29(7):937–44. https://doi.org/10.1111/j.1464-5491.2012.03644.x.

Mohgtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg. 2006;108(5):477–81. https://doi.org/10.1016/ j.clineuro.2005.08.003.

American Diabetes Association. Preventive foot care in people with diabetes. Diabetes Care. 2003;26(suppl 1):s78-9. PMID: 12502623.

American Diabetes Association. Standards of Medical Care in Diabetes- 2014. Diabetes Care. 2014;37(Suppl 1):S14-80. https://doi.org/ 10.2337/dc14-S014.

Ammendola A, Tata M, Aurilio C, et al. Peripheral neuropathy in chronic alcoholism: A retrospective cross-sectional study in 76 subjects. Alcohol and Alcohol. 2001;36(3): 271-5. PMID: 11373267.

Eremenco SL, Cella D, Arnold BJ. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Prof. 2005;28(2):212-32. http://dx.doi.org/ 10.1177/0163278705275342.

University of Michigan Health System [Internet]. Michigan: Regents of the University of Michigan. How to Use the Michigan Neuropathy Screening Instrument. Available from: https://www.med.umich.edu/ mdrtc/profs/documents/svi/MNSI_howto.pdf.

Ziegler D. Treatment of diabetic neuropathy and neuropathic pain: How far have we come? Diabetes Care. 2008;31(Suppl 2):S255-61. https://doi.org/10.2337/dc08-s263. (Retraction published 2012, Diabetes Care. 2012;35(2):456).

Published

2016-08-19

How to Cite

Dagang, D. J., Diestro, J. D., Hamoy-Jimenez, G., Isip-Tan, I. T., & Reyes, J. P. B. (2016). Validation of the Filipino-Translated Version of the Michigan Neuropathy Screening Instrument among Filipino Patients with Diabetes Mellitus Seen at the Philippine General Hospital. Journal of the ASEAN Federation of Endocrine Societies, 31(2), 115. Retrieved from https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/335

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