DOI: http://dx.doi.org/10.18203/2349-3933.ijam20201506

Assessment of vibratory QST abnormality in diabetic patients with special correlation to duration of diabetes

Kaushik Saha, Dipa Saha

Abstract


Background: Peripheral Neuropathy is one of the common microvascular complications in diabetes mellitus affecting both large and small nerve fibres. In present study we have assessed the impairment of vibration perception threshold (VPT) QST that enables evaluation of affection of large myelinated (Aα and Aβ) fibres.   

Methods: Authors used Biothesiometer in our study that served a satisfactory tool for quantitating vibratory sense. In our study 120 diabetic patients between 30 to 60 yrs age group with duration of illness ≤10 yrs, 10-20 years and more than 20 years were subjected to Vibratory QST by instrument (Vibrotherm Dx) at several specific points of feet.

Results: The result observed is, 73.2% (n=22) diabetics with clinical neuropathy show impairment of vibration sense, while 60% of diabetic patients without clinical neuropathy also show impairment of vibration sense. Result suggests involvement of nerve fibres in a subclinical stage in diabetic patients. Relation between vibratory QST and duration of diabetes is also established, Chi-square trend test is done and it shows there is positive trend with duration of diabetes and it is statistically significant p≤0.001.

Conclusions: This study suggests that Vibratory QST should be carried out in every diabetic patient irrespective of clinical neuropathy and duration of diabetes, for early detection, progression & institution of therapy.


Keywords


Diabetic peripheral neuropathy, QST, Vibration perception threshold

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References


Dyck PJ, Kratz KM, Karnes JL, Litchy WJ, Klein R, Pach JM, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort. Neurol. 1993;43:817-24.

Young MJ, Boulton AJM, MacLeod AF, Williams DRR, Sonksen PH. A multicenter study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetol. 1993;36:150-4.

Shy ME, Frohman EM, SOYT, Arezzo JC. QST report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurol. 2003;60(6):898-904.

Van Deusen RW, Sanchez MM, Derr JA, Becker MB, Ulbrecht JS, Cavanagh PR. Vibration perception threshold testing in patients with diabetic neuropathy: ceiling effects and reliability. Diabet Med. 2001;18(6):469-75.

Perkins BA, Olaleye D, Zinman B. Simple screening test for peripheral neuropathy in the diabetes clinic, Diabetes care. 2001;24(2):250-6.

Vinik EJ, Hayes RP, Oglesby A, Bastyr E, Barlow P, Ford-Molvik SL, et al. The development and validation of the Norfolk QOL-DN, a new measure of patients' perception of the effects of diabetes and diabetic neuropathy. Diabetes Technol Ther. 2005;7:497-508.

Gelber DA, Pfeifer MA, Broadstone VL, Munster EW, Peterson M, Arezzo JC et al. Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications. 1995;9(3):170-6.

Sorensen, Lea BHSC, Molyneaux, Lynda RN; QST VIBRATORY of large nerve fibres function is a useful test to detect presence of neuropathy very early. Clin J Pain. 2006;22(3):261-5.

Jamal GA, Hansen S, Weir AI, Ballantyne JP. QST added more accuracy, sensitivity and specificity in diagnosing diabetic neuropathy. The neurophysiologic investigation of small fibre neuropathies. Muscle Nerve. 1987;10:537-45.

Coppini DV, Young PJ, Weng C, Macleod AF, Sonksen PH. Outcome on diabetic foot complications in relation to clinical examination and quantitative sensory testing: a case control study. Diabet Med. 1998;15(9):756-71.