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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

An `Importance' Map of Signs and Symptoms to Classify Diabetic Polyneuropathy: An Exploratory Data Analysis

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Author(s):
Sacco, Isabel C. N. [1] ; Suda, Eneida Yuri [1] ; Vigneron, Vincent [2] ; Sartor, Cristina Dallemole [1]
Total Authors: 4
Affiliation:
[1] Univ Sao Paulo, Sch Med, Dept Phys Therapy & Speech & Occupat Therapy, Sao Paulo - Brazil
[2] Univ Evry, Informat Biol Integrat & Syst Complexes, Evry - France
Total Affiliations: 2
Document type: Journal article
Source: PLoS One; v. 10, n. 6 JUN 15 2015.
Web of Science Citations: 3
Abstract

Aims/Hypothesis Early diagnosis of diabetic polyneuropathy (DPN) is critical for a good prognosis. We aimed to identify different groups of patients, based on the various common clinical signs and symptoms of DPN, that represent a progressive worsening of the disease before the onset of plantar ulceration or amputation. We also sought to identify the most important DPN-related variables that can discriminate between groups, thus representing the most informative variables for early detection. Methods In 193 diabetic patients, we assessed 16 DPN-related signs, symptoms, and foot characteristics, based on the literature and the International Consensus on the Diabetic Foot. We used multiple correspondence analysis and the Kohonen algorithm to group the variables into micro and macro-classes and to identify clusters of patients that represent different DPN conditions. Results Four distinct groups were observed. One group showed no indication of DPN. The remaining groups were characterized by a progressive loss of the vibration perception, without a worsening of symptoms or tactile perception. The 2 intermediate groups presented different aspects of DPN: one showed mostly DPN symptoms and the other showed the incipient vibration impairment, callus and crack formation, and foot arch alteration. The fourth group showed more severe foot and DPN conditions, including ulceration and amputation, absence of vibration and tactile perception (irrespective of how many compromised foot areas), and worse foot deformities and callus and crack formation. Conclusion Vibration perception was more informative than tactile sensitivity in discriminating early DPN onset because its impairment was evident in more groups. Symptoms and callus and cracks did not discriminate the severity status and should be interpreted in association with other clinical variables. Reconsideration of the current screening techniques is needed to clinically determine the early onset of neuropathy using tactile perception. (AU)

FAPESP's process: 13/06123-7 - Dynamic muscles recruitment patterns during gait using high-density EMG of diabetic patients in different severity degrees classified by a fuzzy system
Grantee:Eneida Yuri Suda
Support type: Scholarships in Brazil - Doctorate
FAPESP's process: 11/19304-4 - Influence of physical therapy intervention on foot and ankle biomechanics of gait in diabetic neuropatic individuals: a randomized controlled trial
Grantee:Cristina Dallemole Sartor
Support type: Scholarships in Brazil - Doctorate (Direct)