Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over the time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling or numbness in the hands, arms, legs and feet.
Experts recommend that people with diabetes have a comprehensive foot exam every year to check for peripheral neuropathy. They may assess protective sensation in your feet using a nylon 10 gm monofilament. People who cannot sense pressure from monofilament have lost protective sensation and are at high risk for developing foot ulcers. It is also recommended to assess the loss of vibration perception. Experts may also check temperature perception threshold which is more sensitive than touch pressure and vibration perception. One of the most common reasons for amputation in India is due to neuropathic ulcers.
Diabetics with neuropathy have seven fold increased risk of foot ulcerations. Diabetics are also exposed to 15 fold higher risk of amputation of lower extremities compared to the general population. Vibration perception has been shown to be strongly associated with foot ulceration. VPT determination by using a Biothesiometer has been used to identify peripheral sensory neuropathy and subjects at risk of foot ulcerations.
Biothesiometry, a rapid, portable, and sensitive method of assessing VPTs, has been used on adolescents and adults to identify subclinical neuropathy and to monitor the progress of the disease. In adulthood, VPTs have been shown to be affected by increasing age and to be dependent on height.