Abstract
The present study investigated the relationships between the results of a brief questionnaire survey regarding sensory symptoms in both legs, the Achilles tendon reflex (ATR), and quantitative impairment of the peripheral nerve function in 370 diabetic outpatients. Of the 49 patients (13.2 %) with sensory symptoms in both legs at the time of the survey, 93.5 % had abnormal ATR. A significantly greater impairment in the motor and sensory nerve function and heart rate variability were observed in patients with sensory symptoms compared to those without sensory symptoms. A comparison between patients with sensory symptoms and 53 patients without sensory symptoms matched for sex, age, and A1c levels demonstrated that patients with abnormal ATR had significantly decreased motor nerve conduction velocity and sensory nerve action potential, regardless of the presence or absence of sensory symptoms compared with patients without sensory symptoms and abnormal ATR. While a higher rate of abnormal ATR and a significantly decreased peripheral nerve function were observed in patients with sensory symptoms, a decreased peripheral nerve function was also found in patients with abnormal ATR but without sensory symptoms. These findings indicate that in addition to sensory symptoms, an ATR evaluation should be performed when screening for diabetic neuropathy.
