Assessment of Peripheral Neuropathy Pain by Biothesiometer in Diabetes Mellitus Patients

Abstract

Background:The biothesiometer allows for a quick and accurate measurement of vibration thresholds, which, when combined with centile charts, provides an objective estimate of diabetic peripheral neuropathy progression. The goal of the current study was to assess diabetic patients' early detection of peripheral neuropathy and associated consequences. Materials and Methods: Study was conducted on diabetes patients of medicine department of Maharishi Markandeshwar Super Speciality Hospital, MMIMSR, MM (DU), Mullana, after approval by the Institutional Ethics Committee (IEC). Patients were analysed for the vibration perception threshold (VPT) using Biothesiometer. After receiving their consent, socio-demographic parameters and previous medical history were noted on a case report form and patient's QoL (Quality of Life) was analyzed using Diabetic Neuropathy (DN) 22 QoL questionnaire. The DN4 questionnaire was used to assess the presence of peripheral neuropathy pain. Results: In this research study total of 100 patients participated, of whom 55 were male patients and 45 were female patients The ages of these patients ranged from 26 to 86 years and mean of these patients was 55 years. The patients were divided into two distinct age groups: those under 50 and those above 50. Only 15 patients reported numbness, while the remaining 85 patients reported no abnormal sensations in their feet. However, when left foot and right foot readings were valuate on the biothesiometer, 9 patients had grade 1 say normal (15 volts), 12 patients had grade 2 (16-25 volts), and 79 patients had grade 3 (>25 volts). Conclusion: It was concluded that VPT was determined to be the gold standard or say best fit for detection of peripheral neuropathic pain in diabetes patients. Measuring VPT in diabetic patients with a biothesiometer may reduce the risk of developing neuropathic foot ulcers and foot amputations.

Assessment of the diagnostic accuracy of Vibrasense compared to a biothesiometer and nerve conduction study for screening diabetic peripheral neuropathy

“…Consequently, it is plausible that the observed prevalence in our study is an overestimate of the actual population prevalence of DPN in India. We performed VPT testing at 6 points in the plantar foot as per the protocol recommended by the manufacturers and followed by many centers across India as evidenced from published studies [ 22 – 24 , 27 ]. The other established protocol is testing a single site on the hallux [ 9 , 20 , 21 , 51 ].…”

“…Both devices produce vibration amplitudes from 0.026–25 microns expressed as vibration units that range from 1—50 V, where a higher unit of vibration stimuli indicates a greater sensory loss. Following the protocol recommended by both manufacturers, and consistent with other published Indian studies, VPT measurements were taken at six specific points on the plantar surface of the foot: the great toe, the first-, third-, and fifth-metatarsal heads, the medial side of the midfoot, and the heel [ 22 – 24 , 27 ]. The test was explained to the patient and the vibration probe was applied to the hand of the subject to familiarize them with the expected vibratory sensation.…”

“…To prevent the burden of foot ulcers in India, it is necessary that physicians implement regular DPN screening in their practices [18,19]. Published studies from India indicate that VPT evaluation is being used for the detection of DPN in secondary-and tertiary-care centers [20][21][22][23][24][25][26][27]. However, these devices have not gained widespread usage in primary care practice.…”