Assessing Diabetic Polyneuropathy Prevalence in Hospitalized Patients: A Comparative Study Using the Michigan Self-Report Questionnaire and Physical Examination Methods

TL;DR

This study compares two methods for detecting diabetic polyneuropathy in hospitalized patients and finds a high prevalence of the condition.

Contribution

The study evaluates the agreement between self-report and physical examination methods for DPN screening in hospitalized diabetic patients.

Findings

A moderate agreement (κ = 0.486) was found between the Michigan questionnaire and physical examination for DPN diagnosis.

The overall DPN prevalence was 64.6% when using both methods in combination.

The Michigan questionnaire is suggested as a cost-effective tool for early DPN detection.

Abstract

Background: Chronic complications of diabetes, such as diabetic polyneuropathy (DPN), are major contributors to disability and mortality among diabetic patients. Effective screening for DPN is crucial to prevent severe complications, including limb amputation. This study was aimed at assessing the prevalence of DPN among hospitalized diabetic patients using both self-report (Michigan questionnaire) and physical examination methods and at evaluating the level of agreement between these two screening approaches.

Methods: This cross-sectional study included 158 adult diabetic patients admitted to Shahid Beheshti Hospital in Kashan, Iran, between April and September 2023. Patients were screened for DPN using the Michigan self-report questionnaire and physical examination. Sociodemographic and clinical data were collected through patient interviews and medical records. Random sampling was used to ensure representativeness. Data analysis was conducted using SPSS Version 26, applying descriptive and inferential statistics. Cohen's kappa statistic was used to assess the level of agreement between the two screening methods. The validity and reliability of the assessment tools were confirmed through previous studies.

Results: The study found a moderate agreement between the physical examination and the Michigan self-report questionnaire in diagnosing DPN (κ = 0.486, p < 0.001). The overall prevalence of DPN, based on the agreement of both methods, was 64.6%. The prevalence was 75.9% based on physical examination and 72.8% based on the questionnaire.

Conclusions: This study found a high prevalence of DPN among hospitalized diabetic patients, highlighting the urgent need for effective screening methods. The moderate agreement between the Michigan questionnaire and physical examination suggests that the questionnaire could serve as a simple, cost-effective tool for early DPN detection. Further research and wider implementation of these screening tools may enhance early diagnosis and help reduce the risk of severe complications, such as limb amputation.

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