Endocrine Abstracts

Aim: To assess the utility of early detection of diabetic peripheral neuropathy using Vibration perception threshold (VPT) via digital Biothesiometer and correlation with patient reported symptoms. Type of study: Audit of peripheral neuropathy assessment in all diabetes patients Standard: NICE guideline on Diabetic foot problems (NG 19- Updated October 2019)

Methods: The NICE guidelines recommend neuropathy assessment on all patients with Type 2 Diabetes. 100 consecutive Type 2 diabetes patients attending the OPD of Jeevans Diabetes and Endocrine Centre, Kerala, India were assessed for symptoms of diabetic peripheral neuropathy and subsequently underwent digital Biothesiometry using the Digital Biothesiometer (BIOTHEZI-VPT) to detect any signs of diabetic neuropathy. Biothesiometer is a device which can pick up early cases of neuropathy and works on the principle of an electrical tuning fork. A response to a stimulus value < /= to 15 volts was considered normal; a value of 16-25 volts to appreciate the stimulus was classified as Grade 1 neuropathy and a value of >25 volts was considered as Grade 2 Neuropathy.

Results: 100 patients with Type 2 diabetes were included in the study. 70 patients were female and 30 patients were male. The age range was from 27 – 76 yrs. Only 10 patients reported any symptoms suggestive of peripheral neuropathy. When examined with Biothesiometer, 26 patients had normal (<15 volts) value, 50 patients had grade 1 neuropathy (16-25 volts) and 24 had grade 2 neuropathy (>25 volts) on the Biothesiometer.

Conclusion: Reliance on patient reported symptoms can lead to many patients of diabetic neuropathy going undetected. VPT is considered as a gold standard test for detection of diabetic peripheral neuropathy. Other tests though simple may be biased by subjective observer variation. Use of VPT using Biothesiometer is a simple and sensitive assessment for early detection of significant diabetic peripheral neuropathy in OPD setting.