Vibration perception threshold-a valuable assessment of neural dysfunction in pe

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Diabetes Metab Res Rev. 2006 Jun 2

Vibration perception threshold-a valuable assessment of neural

dysfunction in people with diabetes.

Garrow AP, Boulton AJ.

Diabetes Foot Clinic, Disablement Services Centre, Withington

Hospital, Manchester, UK.

Diabetic peripheral neuropathy (DPN) has been identified as a key

element in the causal pathway to foot ulceration and other lower-

extremity complications, impaired quality of life and increased

mortality. Early detection is essential to optimise effective risk

management, including adequate foot care, patient education, and

future pharmacological therapy.

However, data suggest that screening has been mostly sub-optimal, and

many physicians remain unfamiliar with non-invasive screening tests.

There is evidence in the literature to suggest that vibration

perception threshold (VPT) measures can be used to easily and

accurately identify at-risk diabetic patients, including those with

early neuropathic deficits. These measures have been used in

population-based studies and are associated with an increased risk of

severe and expensive outcomes, such as ulcers and amputations.

Incorporating VPT testing into clinical practice has the potential to

significantly improve the outcomes in patients with DPN, thereby

substantially reducing the socio-economic burden of this common and

challenging disease.