Escores de neuropatia periférica em diabéticos

OBJETIVO: Diabetes mellitus e uma doenca cronica prevalente, associada a inumeras complicacoes. A neuropatia periferica diabetica e a mais comum, acometendo 50% dos diabeticos, mas muitas vezes nao e diagnosticada. Por cursar com insensibilidade distal e alteracoes arquiteturais dos pes, predispoe a ulceras, podendo culminar no pe diabetico com risco de amputacao. O diabetes mellitus e responsavel por 70% das amputacoes de membros, que poderiam ser prevenidas com o diagnostico precoce da neuropatia periferica diabetica. Sugere-se avaliar o grau de neuropatia em diabeticos por meio de escores, visando homogeneizar o diagnostico, quantificar a prevalencia e promover medidas preventivas. METODOS: Realizou-se entrevista, exame fisico e coleta de dados de diabeticos atendidos ambulatorialmente, para pontuacao e qualificacao no Escore de Sintomas Neuropaticos e no Escore de Comprometimento Neuropatico, validados na lingua portuguesa para avaliar neuropatia periferica diabetica, alem de analise das caracteristicas clinicas e epidemiologicas associadas. RESULTADOS: Foram incluidos 116 pacientes, constatando-se neuropatia periferica diabetica em 31,9%. Houve correlacao significativa de neuropatia periferica diabetica coma idade dos pacientes, mas nao com as demais variaveis clinicas e laboratoriais. Os pacientes avaliados apresentaram medias de idade de 55±15 anos e tempo de diabetes de 14,8±10,9 anos, sendo predominantemente caucasianos, mulheres e portadores de diabetes mellitus tipo 2. Eram hipertensos 67,2% e 42,2%, obesos. CONCLUSAO: A prevalencia encontrada corrobora a literatura, embora poucos estudos tenham utilizado criterios similares para diagnosticar neuropatia periferica diabetica. Empregando os escores padronizados, de baixo custo e facil aplicacao possibilitamos o diagnostico precoce e embasado dessa entidade, sendo possivel, com isso, reduzir a prevalencia de graves complicacoes do pe diabetico e disseminar informacoes a respeito. OBJECTIVE: Diabetes mellitus is a prevalent chronic disease, associated with numerous complications. Diabetic peripheral neuropathy is the most common, affecting 50% of diabetics, although is often not diagnosed. Presenting with distal numbness and architectural alterations of the feet, it predisposes ulcers and may culminate in diabetic foot at risk for amputation. Diabetes mellitus is responsible for 70% of limb amputations, which could be prevented with early diagnosis of diabetic peripheral neuropathy. This study aims to evaluate the degree of neuropathy in diabetics through validated scores, in order to standardize the diagnosis, quantify the prevalence and promote preventive actions. METHODS: We performed an interview, physical examination and data collection of diabetic outpatients, for rating in the Neuropathy Symptom Score and the Neuropathy Disability Score, validated in Portuguese, to assess diabetic peripheral neuropathy, in addition to analysis of clinical and epidemiological associated characteristics. RESULTS: We included 116 patients and diabetic peripheral neuropathy was found in 31.9%. There was significant correlation diabetic peripheral neuropathy with age, but not with other clinical and laboratory variables. The mean age was 55±15 years, diabetes duration was 14.8±10.9 years and patients were predominantly Caucasian, women and had type 2 diabetes mellitus. Of the patients, 67.2 % were hypertensive and 42.2% obese. CONCLUSION: The prevalence found is supported by previous data, although few studies have used similar criteria to diagnose diabetic peripheral neuropathy. Employing the standard scores, of low cost and easy implementation, we enable early and accurate diagnosis of this condition, allowing to reduce the prevalence of severe diabetic foot complications and spread information about it.