[Vibratory and cooling detection thresholds in diabetes mellitus].

Vibratory and cooling detection thresholds (VDT and CDT) were determined at both the palmar aspect of the distal phalanx of the right index finger (upper limb) and the plantar aspect of the distal phalanx of the right great toe (lower limb) in 53 consecutive patients with diabetes mellitus (NIDDM), in order to analyze the frequency of the abnormality of each threshold and the relationship between each threshold and the clinical or laboratory findings. VDT in the lower limb was statistically correlated with age, duration of diabetes mellitus, and blood urea nitrogen value of each patient, but not with fasting blood glucose and hemoglobin A1C levels. VDT in the lower limb was significantly greater in the groups of patients with each of the subjective sensory disturbances, peripheral neuropathy (based on our criteria), retinopathy, and proteinuria. Forty-seven per cent of the patients showed clinically peripheral neuropathy, and the frequencies of the abnormality of VDT, CDT and VDT or CDT were 34, 26 and 45%, respectively. VDT and CDT reflect the abnormality of different populations of the peripheral nerve fibers and seem to be affected separately. The determination of both VDT and CDT is useful for the evaluation of the neuropathic state of diabetic patients.