Endocrine Abstracts

Introduction: Diabetic neuropathy affects up to 50% of the patients with long standing diabetes mellitus. The duration of diabetes and glycaemic control are correlated with the development of neuropathy. Distal symmetrical neuropathy results in numbness which facilitates ulcer development. Biothesiometry provides a quantitative assessment of neuropathy. Patients with threshold >25 V (grade II) are at a high risk of developing ulcers later.

Aim: To detect peripheral diabetic neuropathy early and correlate it with the duration of diabetes at Federal Medical Centre, Abeokuta, Nigeria.

Methodology: A biothesiometer vibrometer machine was used. The amplitude of the stimulus (measured in volts) was gradually increased until the threshold of vibratory sensation was reached and the stimulus was appreciated by the patient. The results were recorded on a paper showing the neuropathy points on both right and left foot.

Results: Fifty diabetic patients were included in the study, out of which 28(56%) were females and 22(44%) were males. The duration of diabetes was 1month – 35years with a mean of 5.9 years. The mean value for the right and left foot was found to be 16.44 and 16.02 V respectively with the minimum values for both feet being 1 V and maximum for right and left foot 48 and 42 V respectively. Fifty per cent of patients with diabetes duration less than 5 years were considered to be normal (stimulus <15 V) while 50% had various degrees of neuropathy.

Discussion: Biothesiometer can detect sensory neuropathy even if the patient does not have any symptom of neuropathy. This study further shows the importance of early education on foot care in those with diabetes.

Conclusion: The biothesiometer detects peripheral neuropathy and grade its severity and thus predict future development of neuropathic foot ulcers. Steps needed to reduce the risk of ulcers and amputations can then be taken early.