Endocrine Abstracts

Introduction: Type 1 diabetes affects a large number of children and adolescents, and its incidence is on the rise worldwide. The most devastating and important consequence of diabetes is its role in the development of long-term microvascular complications. This study aimed to study the role of the non-invasive vibration perception threshold (VPT) test in detecting subclinical peripheral neuropathy, and its correlation with metabolic control and duration of disease in British children with type 1 diabetes.

Methods: This prospective study was carried out in the paediatrics outpatients department of a secondary care centre with a specialist diabetes team. Children over the age of 18 and those with obvious neurological or foot disease were excluded. The patients had HbA1c and BMI measured, and the duration of diagnosis to the clinic appointment was calculated. The VPT measurements were taken by applying a probe to the big toes of the patients’ feet and recording the lowest value when the patient reported a vibratory sensation. Statistical analyses were performed between the variables to determine significant correlations.

Results: 90 patients were identified, and 70 patients (32 males and 38 females) met the inclusion criteria. The median HbA1c was 8.0%, median BMI 18.8, and mean duration of disease 4.6 years (S.D. – 2.57 years). The mean VPT in the left and right toe were 2.71 (S.D. – 1.13) and 2.87 (S.D. – 1.19) respectively. VPT was significantly correlated to age and height, but not to HbA1c and disease duration. HbA1c was significantly correlated with age, disease duration and BMI (P<0.05).

Conclusions: This was the first study carried out in the UK within a paediatric cohort. Although no clinically important correlations could be demonstrated, VPT could still be used in a clinical setting to introduce the discussion to promote adequate glycaemic control and foot care.