Evaluation of vibration sensitivity violation as early diagnosis of diabetic distal polyneuropathy in patients with type 2 diabetes

Abstract

Distal sensorimotor polyneuropathy (DSPN) is a severe complication and the most common form of peripheral neuropathies in patients with type 2 diabetes (T2D). Nowadays, interest in the DSPN has increased significantly due to the increase of incidence of T2D, as well as the severity of its clinical manifestations.This study aimed to assess the prevalence of DSPN in patients with T2D using Vibratip device as an alternative test for early diagnosis of vibration perception disorders.Design and methods. This study was a cross sectional observational design. Height, weight, body mass index (BMI), systolic and diastolic blood pressure measured according to standard protocol. The information about T2D duration and treatment, diabetic complications, concomitant diseases and its treatment, data about laboratory parameters (level of HbA1c during the last six months, total cholesterol and triglycerides) collected from local database. All participants examined with Vibratip on both feet. Vibratip is new device using standardized vibration for DSPN detection. Vibratip is applied to the patients feet, testing two sites on both feet (1st metatarsal head on the plantar surface and hallux pump) - once whilst non-vibrating and once whilst vibrating and the patients (with their eyes closed) is asked to indicate when they feel the vibration.Results. 2757 women and 1546 men aged 22-89 years selected from the six regions of the Republic of Belarus and Minsk-city. Among the 4303 subjects 7.78% (n=335) took place in this study aged less than 45 years (young patients), 65.4 % (n=2814) aged 45-65 years and 26.49 % (n=1140) aged more than 65 years old. Average age was 59 ±10.4; average body mass index (BMI) – 32.2±5.6 kg/m2. Participants with normal body mass index composed 9.02% (n=388), participants with superfluous body mass and obesity – 91% (n=3915). 710 (16.5%) participants were smoking, 2649 (61 %) suffered from high blood pressure. The most participants 1428 (33%) were treated by statins compared with fibrates 131 (3%). In patients with clinical symptoms of DSPN more often was pain (in 775 cases - 18.0%), burning (in 775 cases - 16.4%), numbness (in 1144 cases - 26.6%), feeling of pins and needles (in 921cases - 21.4%) and feeling of electric shock (in 235 cases - 5.5%). In patients with vibration sensitivity disorders were subjects with previous diagnosis of DSPN 1813 (42.13%) and subjects without previous diagnosis of DSPN 850 (19.75%). Amount subjects with asymptomatic vibration sensitivity disorder without clinical symptoms DSPN was 1640 (38.12%).Conclusions. In 20% of patients T2D with impaired vibration sensitivity, established with the device Vibratip, defined pre-clinical stage of DSPN. Given the ease of use of the device Vibratip advisable its use as a screening method for early diagnosis of DSPN in clinical practice.