Diabetes mellitus (DM) is considered the major cause of non-traumatic limb
amputation, the impact on patient, family and community psychologically and physically is
overwhelming. The aim of this study was to determine the lower limb amputation risk by
application of Neuropathy Disability Score. This is a case series study involving 712 patients with
DM type II admitted at National Diabetic Hospital (Tripoli) from June 2015 until Jan 2016. One
hundred patients who were diagnosed with diabetic peripheral neuropathy (DPN) were selected.
Verbal consent was taken for each patient. A special Performa was completed for each patient that
included details about patient’
s demographics, some important points in clinical history, relevant
investigations and clinical examination (application of NDS) were recorded. The study reported
100 patients diagnosed with DPN out of 712 admitted patients with DM type II within a study
period (the prevalence was 14%). 76% of them was female and their age range was between 40 -
87 years with a mean age of 62.45 ± 11.34 years. The duration of diabetes was ranged from newly
diagnosed to 40 years with a mean 12.7 ± 9.5 years. 17% of them have morbid obesity (BMI >
40), 76% have neuropathy symptoms, 84% were non-smoker, 40% hypertensive and 34% on
treatment of lipid lowering drugs. Calculation of Neuropathy Disability Score (NDS) to each
patients has shown that 67 out 100 patients had NDS ≥ 6 which was 52 of them were female. Their
mean age was 64.4 years, mean duration of DM was 15 years and mean HBA1c was 9.7 g% with
all were symptomatic. In conclusion, the usefulness of commonly used bed side tests to screen for
DPN with a predominant focus on application of NDS, that patient had increased risk of lower
limb amputation within one year when NDS more than six.
Keywords: NDS; neuropathy disability score, diabetic peripheral neuropathy, BMI, Libya.