Michigan Diabetic Neuropathy Symptom score (DNS)
2-very, neuropathic pain, pain
DNS combines scores from a neurological examination and standard nerve conduction stimulation. A 128-hertz diapason generates vibration to calculate this variable, and pain is induced on the back of the examinee’s toe using a sharp tool. During this procedure, the examinee is asked yes/no questions and is expected to answer. Responses with seven or more correct answers and one to seven or no correct answers are interpreted as average, weak, or lack of sensation, respectively. In addition, muscular strength is also examined in the distal muscles and rated on ranges of 0-normal, 1-weak-medium, and 2-very weak. Score 3 is given when examinee’s are unable to contract their muscles deliberately. The current tendon reflexes requiring facilitation and having no reflexes are scored by 0, 1, and 2, providing a maximum total score of 46. Higher scores than six are associated with neuropathic pain [