Prevalence of Distal Symmetrical Polyneuropathy in Type2 Diabetes, IWGDF Category 0, Aged 18-55 Years: a Cross-Sectional Study Using Nerve Conduction
Keywords:
diabetic neuropathy, nerve conduction, diabetic footAbstract
This study aimed to explore the prevalence of distal symmetrical polyneuropathy (DSPN) among patients with type 2 diabetes mellitus, aged 18-55 years, who were classified as having a very low risk of developing foot ulcers. A cross-sectional descriptive study was conducted with a sample of 100 participants at the Social Security Clinic, Saraburi hospital. Nerve conduction study was utilized as the gold standard for diagnosis in conjunction with the Michigan Neuropathy Screening Instrument (MNSI). Data were analyzed using binary logistic regression. The results showed that the prevalence of DSPN was as high as 30%, even though the patients had an average disease duration of only 4.7 years. Important factors significantly related to the condition included diabetic retinopathy (adjusted OR=42.564), abnormal Tibial nerve conduction (adjusted OR=11.242), abnormal Medial plantar nerve conduction (adjusted OR=7.876), and abnormal MNSI history scores (adjusted OR=11.775). These findings indicated that nerve damage could occur in the early stages before clear symptoms appear, which might cause it to be overlooked during routine screenings. In conclusion, patients with a very low risk of foot ulcers still had a hidden risk of neuropathy. The study suggested that healthcare providers should focus on clinical history and effective tools like MNSI history section. Additionally, referring patients for specific nerve tests should be encouraged to prevent serious complications in the future.
Downloads
References
McDermott K, Fang M, Boulton AJ, Selvin E, Hicks CW. Etiology, epidemiology, and disparities
in the burden of diabetic foot ulcers. Diabetes Care 2023;46(1):209-21.
Dyck PJ, Albers JW, Andersen H, Arezzo JC, Biessels GJ, Bril V, et al. Diabetic polyneuropathies:
update on research definition, diagnostic criteria and estimation of severity. Diabetes Metab
Res Rev 2011;27(7):620-8.
Edmonds M, Manu C, Vas P. The current burden of diabetic foot disease. J Clin Orthop
Trauma 2021;1(17):88-93.
Thirapatarapong W, Srisawasdi G. Epidemiology and direct cost of diabetes-related lower
extremity amputations at Siriraj Hospital. J Rehabil Med 2008;18(2):65-9.
ราชวิทยาลัยอายุรแพทย์แห่งประเทศไทย, สมาคมโรคเบาหวานแห่งประเทศไทย. แนวทางเวชปฏิบัติสำหรับ
โรคเบาหวาน พ.ศ. 2566 [อินเทอร์เน็ต]. 2566 [สืบค้นเมื่อ 26 ก.ย. 2568]. แหล่งข้อมูล:
https://cpg.dms.go.th/ebooks/แนวทางเวชปฏิบัติสำหรับโรคเบาหวาน-2566
Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Fitridge R, Game F, et al. Practical guidelines
on the prevention and management of diabetes-related foot disease (IWGDF 2023 update).
Diabetes Metab Res Rev 2023;27:e3657.
นีรนาท สีมะสิงห์, พิชญ์ พหลภาคย์, สว่างจิต สุรอมรกูล. ความชุกตามระดับความเสี่ยงของการเกิดแผลเท้าเบา
หวานในผู้ป่วยเบาหวานชนิดที่ 2. วชิรเวชสารและเวชศาสตร์เขตเมือง 2564;65(ฉบับเพิ่มเติม):63-74.
รัชฎา สหะวรกุลศักดิ์. การศึกษาความชุกตามระดับความเสี่ยงของการเกิดแผลเบาหวานที่เท้า. วารสารศูนย์การ
ศึกษาแพทยศาสตร์คลินิก โรงพยาบาลพระปกเกล้า 2556;30(1):71-2.
Ziegler D, Papanas N, Schnell O, Nguyen BD, Nguyen KT, Kulkantrakorn K, et al. Current
concepts in the management of diabetic polyneuropathy. J Diabetes Investig 2021;12(4):
-75.
Uluc K, Isak B, Borucu D, Temucin CM, Cetinkaya Y, Koytak PK, et al. Medial plantar and
dorsal sural nerve conduction studies increase the sensitivity in the detection of neuropathy
in diabetic patients. Clin Neurophysiol 2008;119(4):880-5.
Hasan MM, Shokry AE, Mohamad SK, El AF. Sural and medial plantar nerve conduction
study in the diagnosis of subclinical diabetic neuropathy. Al-Azhar Assiut Medical Journal
;19(3):446-51.
กรมกิจการผู้สูงอายุ. สถานการณ์ผู้สูงอายุไทย พ.ศ. 2566. กรุงเทพมหานคร: โกโก้พริ้นท์; 2567.
กองโรคไม่ติดต่อ. รายงานประจำปี 2568 กองโรคไม่ติดต่อ กรมควบคุมโรค. กรุงเทพมหานคร:
อักษรกราฟฟิกแอนด์ดีไซน์; 2569.
Weng YC, Tsai SS, Lyu RK, Chu CC, Ro LS, Liao MF, et al. Diabetic distal symmetrical
polyneuropathy: correlation of clinical, laboratory, and electrophysiologic studies in
patients with type 2 diabetes mellitus. J Diabetes Res 2020;2020(1):6356459.
ศิรินาถ ตงศิริ, ภัทราวุธ อินทรกำแหง, เฟื่องฟ้า คุณาดร. การศึกษาค่าปกติของการนำกระแสประสาท
ของเส้นประสาท median, ulnar, tibial, common peroneal และ sural ในโรงพยาบาลพระมงกุฎเกล้า.
เวชศาสตร์ฟื้นฟูสาร 2541;8(1):151-7.
Ponsford SN. Sensory conduction in medial and lateral plantar nerves. J Neurol Neurosurg
Psychiat 1988;51:188-91.
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 1994;17(11):1281-9.
Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening
instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg 2006;108(5):477-81.
Damri T, Chatchawan U. Validity and reliability of the Michigan Neuropathy Screening
Instrument (MNSI) on the Diabetic type II patients (Thai version). Journal of Medical
Technology and Physical Therapy 2015;27(3):307-19.
Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: clinical-
electrophysiologic correlations. 3rd ed. Philadelphia: Elsevier Saunders; 2013.
Chaisakul J, Ukritchon S, Rangsin R, Mungthin M. Prevalence of peripheral neuropathy in
Thai patients with type 2 diabetes and associated risk factors. J Med Assoc Thai
;103(3):254-61.
Liu X, Xu Y, An M, Zeng Q. The risk factors for diabetic peripheral neuropathy: a meta-
analysis. PLoS ONE 2019;14(2):e0212574.
Yang T, Qi F, Guo F, Shao M, Song Y, Ren G, et al. An update on chronic complications of
diabetes mellitus: from molecular mechanisms to therapeutic strategies with a focus on
metabolic memory. Molecular Medicine 2024;30(1):71.
Lee CG, Ciarleglio A, Edelstein SL, Crandall JP, Dabelea D, Goldberg RB, et al. Prevalence of
distalsymmetrical polyneuropathy by diabetes prevention program treatment group,
diabetes status, duration of diabetes, and cumulative glycemic exposure. Diabetes Care
;47(5):810-7.
Herman WH, Pop-Busui R, Braffett BH, Martin CL, Cleary PA, Albers JW, 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. Diabetic Medicine
;29(7):937-44.
Jin HY, Park TS. Can nerve conduction studies detect earlier and predict clinical diabetic
neuropathy? J Diabetes Invest 2015;6(1):18-20.
Yamanyar GK, Aslan H. The role of medial plantar nerve conduction studies in the diagnosis
of diabetic polyneuropathy: A comparative analysis with sural nerve. European Research
Journal 2025;11(6):1184-91.
Carrington AL, Shaw JE, Van Schie CH, Abbott CA, Vileikyte L, Boulton AJ. Can motor nerve
conduction velocity predict foot problems in diabetic subjects over a 6-year outcome
period?. Diabetes Care 2002;25(11):2010-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ministry of Public Health

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

