Original Title: Complicaciones de la diabetes. Neuropatía diabética

Authors' objectives: Facilitate the decision making based on the evidence for the creation of screening programmes of DN, providing information about, when the first screening should be carried out and, with what frequency should be repeated in people diagnosed with DM, whether type I (DM1) or type II (DM2), assuming the Semmes-Weinstein monofi lament 5,07 (10g) as a proper tool for detecting diabetic peripheral neuropathy (DPN).

Authors' results and conclusions: After carrying out a discrimination of identifi ed documents, two studies, four CPG and a health technology assessment report that could provide relevant information to reach the objectives of this work were selected. The two selected studies add information on the existing relationship between DN and the evolution of the DM. A study shows the increase of the prevalence of DN according to the years evolution of DM in 60 patients. In the group of people with less than 5 years of evolution of DM the prevalence fluctuates between 7% and 34%; among people whose duration of the diabetes is between the 5 and 10 years, it fl uctuates between 24% and 62%; and in the group of people with more than 10 years of evolution of DM, it is between 41% and 72%. The second study shows that 29% out of the 175 individuals with no DN, re-examined after an average of follow-up of 4.1 years developed DN. The CPG coincides with the health technology assessment report recommending annual screening programmes for DPN. However, some differences can be observed between them regarding the moment in which these programmes should begin. Although it is fair to say that all coincide in which the screening for DN should begin at the time of the diagnosis of DM2, one CPG and the technical appraisal report recommend to begin it at the same moment of the diagnosis of the DM1 and the rest three CPG after 5 years of evolution of the DM. The literature search shows the lack of observational studies that describe the appearance of DN over time in connection with the evolution of the DM, being the available evidence based only on transversal studies. In any case, for patients with DM1 the CPG/health technology assessment report recommend mainly to begin the screening after 5 years of the diagnosis of the illness or, in minority, at the same moment of the diagnosis. For patients with DM2 all the CPG recommend to begin the screening at the same moment of the diagnosis justifying it by the possible hidden periods of hyperglycaemia previous to the diagnosis of DM. Regardless of the type of the DM, all the identifi ed documents recommend the frequency to perform the screening for DN should be annually.

Authors' methods: A search of published articles between 2003 and 2010 was carried out in the databases such as Medline (PubMed), Embase, Cochrane Library Plus, Cochrane Library, IME (Índice Médico Español), IBECS (Índice Bibliográfico Español en Ciencias de la Salud), and LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud). It was also search in databases of the Centres for Reviews an Dissemination (CRD), that include HTA (Health Technology Assesment), DARE (Database of Abstracts of Reviews of Effectiveness) about reviews of effectiveness and NHSEED (National Health Service Economic Evaluation Database) about economic evaluation; and the national and international websites of the Agencies for the Health Technology Assessment. Additionally, a specifi c search took place to fi nd clinical practice guidelines (CPG) in specialised search engines as Trip Database and Clinical Excellence, as well as directly in websites, catalogs and so on from other organisations that develop and compile CPG. Those studies and reviews that provided information regarding the relation between DN, the evolution of the DM and/or the screening for DN were selected.

Project Status: Completed

Year Published: 2010

URL for published report: https://www.iacs.es/wp-content/uploads/2017/04/446_Neuropat%C3%ADa_diabetes_IACS.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Health Sciences Institute in Aragon (IACS)

Contact Address: Avda, San Juan Bosco, 13, planta 2

Contact Name: María Pilar Calvo Pérez

Contact Email: direccion.iacs@aragon.es