Low and High Frequency Vibration Perception Thresholds Can Improve the Diagnosis of Diabetic Neuropathy (original) (raw)
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Diabetes Care, 2010
OBJECTIVE To describe the sensitivity, specificity, positive predictive value, and negative predictive value of vibration perception threshold (VPT) testing in subjects with type 1 diabetes relative to gold standard assessments of peripheral neuropathy. RESEARCH DESIGN AND METHODS VPT was determined in 1,177 adults with type 1 diabetes 13–14 years after participating in a study of intensive (INT) versus conventional (CONV) diabetes treatment. Abnormal VPT was defined by values exceeding 2.5 SD above age-specific normal values. Signs and symptoms of peripheral neuropathy were assessed and electrodiagnostic studies were performed to establish definite clinical neuropathy, abnormal nerve conduction, and confirmed clinical neuropathy (the presence of both definite clinical neuropathy and abnormal nerve conduction). RESULTS Thirty-seven percent of subjects had definite clinical neuropathy, 61% had abnormal nerve conduction, and 30% had confirmed clinical neuropathy. Abnormal VPT was more...
Relative sensory sparing in the diabetic foot implied through vibration testing
Diabetic Foot & Ankle, 2013
Background: The dorsal aspect of the hallux is often cited as the anatomic location of choice for vibration testing in the feet of diabetic patients. To validate this preference, vibration tests were performed and compared at the hallux and 5th metatarsal head in diabetic patients with established neuropathy. Methods: Twenty-eight neuropathic, diabetic patients and 17 non-neuropathic, non-diabetic patients underwent timed vibration testing (TVT) with a novel 128 Hz electronic tuning fork (ETF) at the hallux and 5th metatarsal head. Results: TVT values in the feet of diabetic patients were found to be reduced at both locations compared to controls. Unexpectedly, these values were significantly lower at the hallux (P B0.001) compared to the 5th metatarsal head. Conclusion: This study confirms the hallux as the most appropriate location for vibration testing and implies relative sensory sparing at the 5th metatarsal head, a finding not previously reported in diabetic patients.
BMJ, 1984
A series of 519 non-diabetic subjects had vibration thresholds at three points measured using a biothesiometer. Thresholds appeared to be log normally distributed and increased with age. Centile charts of this relation were derived from the data giving a range for normal thresholds. The biothesiometer provides a quick and reliable assessment of vibration thresholds, which when related to the centile charts gives an objective measure of the progress of diabetic peripheral neuropathy.
Postgraduate Medical Journal, 2011
Purpose of the study Distal peripheral neuropathy (DPN) is a troublesome complication of diabetes mellitus (DM). The factors associated with the disease are still incompletely understood. The purpose of this study was to investigate factors associated with vibration perception threshold (VPT) as a marker of DPN in a type 2 diabetic population with advanced microvascular disease. Methods The study included 203 diabetic patients (117 male, 86 female) with proliferative diabetic retinopathy. Subjects were investigated by questionnaires, clinical examinations, blood and urine sampling, and review of medical records in the period from November 2008 through April 2009. Presence of DPN was defined as VPT ≥25 V. Results The mean (±SD) age was 65.2 (±9.9) years and median (IQR) diabetes duration was 18 (10–25) years. Forty-six per cent of subjects were found to have DPN, defined as a VPT ≥25 V by neurothesiometer testing. Prevalence of DPN was found to be associated with age (p=0.038), male ...
The International Journal of Lower Extremity Wounds
Foot ulcers, infections, and deformity are some of the major sources of mortality and morbidity among the diabetic population. The relationship between glycated hemoglobin (HbA1c) and diabetic peripheral neuropathy (DPN) has been well established. There is a dearth of literature on the relationship between vibration perception threshold (VPT) and HbA1c values. So, the objective of the study was to determine the strength of linear relationship between HbA1c levels and vibration perception threshold in DPN. This cross-sectional study was conducted at Kasturba Hospital, Manipal, and diabetic foot screening camps held at various parts of Udupi district. Ethical approval was obtained from the Institutional Ethics Committee, Kasturba Hospital, Manipal (IEC:281/2017). A total of 534 participants ranging from 30 to 70 years of age and were diagnosed with type 2 diabetes mellitus on medications were included in the study. Neuropathy assessment consisting of monofilament and vibration percept...
Journal of Diabetes and its Complications, 1995
Vibration perception threshold 0 was measured in 1185 Indian, Creole, and Chinese men and women in Mauritius, where the current prevalence of diabetes mellitus in adults aged 25-74 years is estimated to be 13%. Vibration perception threshold was measured using a biothesiometer, at seven sites in the hand, wrist, foot, and ankle, during a population survey in 76% of 574 known diabetic patients (KDM), 79% of 525 newly diagnosed diabetic patients (NDM), 18% of 1121 subjects with impaired glucose tolerance (IGT), and in 127 normal subjects. The association of VPT with glucose tolerance and other risk factors was assessed in order to identify individuals most at risk of foot ulceration and to determine whether risk factors and normal levels for VPT in these ethnic groups were consistent with those reported for Caucasians. After adjusting for age and height, geometric mean VPT at six of seven sites increased significantly with worsening glucose tolerance and increasing duration of International Diabetes Institute (A.
International Journal of Environmental Research and Public Health, 2020
Background: Diabetes mellitus is a chronic disease characterized by fasting hyperglycemia. It affects approximately 415 million people worldwide and involves a variety of complications. One of them is the loss of sensitivity to peripheral vibration. Objective: Our study aims to discover the test-retest reliability of a procedure for assessing vibration sensitivity in people with type 2 diabetes mellitus. Methodology: 90 people with type 2 diabetes mellitus (56 men and 34 women) performed the vibration perception threshold (VPT) test using the Vibratron II device. A re-test was completed seven days after the first reading. Results: The relative reliability of the VPT test result is excellent (intraclass correlation coefficient = 0.96). The same applies to gender and obesity subgroups. Regarding absolute reliability, the standard error of measurement is 8.99%, and the small real difference is 24.94%. Conclusions: The relative and absolute reliability results of the vibration perceptio...
2020
Diabetic Peripheral Neuropathy (DPN) is one factor which can lead the diabetes mellitus patient to foot ulceration. Early detection is indispensable part to prevent diabetes mellitus patient from foot disorders. vibration perception threshold (VPT) measures can be used to easily and accurately identify presence of DPN. This study was to test the reliability and to evaluate the accuracy of a new vibrometer for detection DPN. A new device (Neovibrometer) was compared with 10g monofilament and tested on a group of DPN and a group of healthy as matched control subjects. Vibration Perception Threshold (VPT) was tested on the plantar surface of the feet. The Neo-vibrometer shows an actual measurement in all test. The Pearson correlation coefficient was 0.94 (P<0.05). The 10g monofilament could also be measured with excellent reliability but only within a limited range of mild to moderate neuropathy, so it appears to be an appropriate screening tool. The measurement-to-measurement intra...