Does strength and quality of life correctly classify people with diabetes according to neuropathy assessments?

Background Diabetes Mellitus (DM) cause a high burden to health systems. Information pertaining to health-related quality of life could be useful towards a better understanding between DM and functioning. Objective To investigate the association between muscle strength and quality of life according to the severity of neuropathy in people with DM using different classification methods. Methods A total of 67 participants were recruited in a rehabilitation centre and stratified into groups. Isometric ankle dorsiflexor muscle strength was assessed using a portable dynamometer and quality of life (utility) was assessed by the EQ-5D-3L questionnaire. Neuropathy was assessed using The Michigan Neuropathy Screening Instrument (MNSI) and the Neuropathy Disability Score (NDS). A multinomial logistic regression was performed to estimate the association between a set of variables, and the neuropathy classification methods. Results Most participants were women aged >60 years, with a mean diagnosis of DM of 16.1 years. The mean utility was 0.66, with those with neuropathy having the worst utility. Female gender was associated with a lower chance of developing neuropathy when compared with individuals with mild (OR: 0.15) and moderate (OR: 0.11) neuropathy. Increased ankle dorsiflexor strength was associated with a lower chance of developing neuropathy compared to those without loss of sensation (OR:0.62). Conclusion Women with diabetes were less likely to be classified as having loss of sensitivity and had a lower utility compared with men. Individuals with neuropathy reported the worst utility scores. Moreover, increased ankle dorsiflexion strength was associated with lower chance of having neuropathy.