Kelshikar Saili, Athavale Virendra, Parekh Rushabh A, Ranka Miten
General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to Be University), Pune, IND.
Cureus. 2024 Oct 1;16(10):e70588. doi: 10.7759/cureus.70588. eCollection 2024 Oct.
Diabetic foot ulcers (DFUs) have become a common and serious outcome of diabetes mellitus (DM). Diabetic peripheral neuropathy (DPN) is often underdiagnosed, which impairs the capacity to prevent foot ulceration. The clinical manifestations typically include sensory complaints, which leave patients vulnerable to increased risk of injury without their awareness.
The current study aims to assess the viability of VPT (vibration perception threshold) testing using a biothesiometer as an early diagnostic tool for detecting diabetic neuropathy and reducing the burden of diabetic foot disease.
This prospective study was conducted in Dr. D. Y. Patil Medical College, Pimpri, Pune from August 2022 to July 2024 among 50 patients with DFUs. Ethical approval was taken from the Institutional Ethical Committee. An informed consent was obtained from all the study participants. VPT testing using a biothesiometer was done to assess the neurological status of the patient's limbs. A significant difference between the symptomatic and asymptomatic cases was also calculated to evaluate the co-relation of symptoms compared to VPT.
The largest age group among those surveyed is 41-50 with a mean age of 50.72. Males form a slightly larger proportion than females. A total of 22 (44%) ulcers are present over the plantar aspect of the foot. Out of the entire study, 37 (74%) individuals reported Grade II or III neuropathy, and 29 (58%) individuals reported no symptoms of diabetic neuropathy. The majority portion of individuals in the study had an HbA1c ranging from 6.5% to 8%. After an intervention, 44 (88%) patients did not experience a change in their VPT grading after six months.
The chi-square test results suggest that the onset period of diabetes in years or the type of treatment history for diabetes does not significantly influence VPT grading among the surveyed individuals. However, individuals with higher HbA1c levels tend to exhibit more severe VPT impairments.
Regular monitoring of VPT grading is crucial for early diagnosis of neuropathy, tracking disease progression, and assessing intervention effectiveness. Hence, we recommend all diabetic patients regularly undergo biothesiometry as part of their routine diabetic check-ups to help prevent disease progression and complications like amputations and improve their overall quality of life.
糖尿病足溃疡（DFU）已成为糖尿病（DM）常见且严重的后果。糖尿病周围神经病变（DPN）常常未被充分诊断，这削弱了预防足部溃疡的能力。其临床表现通常包括感觉异常，使患者在毫无察觉的情况下受伤风险增加。
本研究旨在评估使用生物感觉阈值测量仪进行振动觉阈值（VPT）测试作为检测糖尿病神经病变及减轻糖尿病足疾病负担的早期诊断工具的可行性。
本前瞻性研究于2022年8月至2024年7月在普纳皮姆普里的迪帕克·帕蒂尔医学院对50例糖尿病足溃疡患者开展。获得了机构伦理委员会的伦理批准。所有研究参与者均签署了知情同意书。使用生物感觉阈值测量仪进行VPT测试以评估患者肢体的神经状态。还计算了有症状和无症状病例之间的显著差异，以评估与VPT相比症状的相关性。
接受调查的人群中年龄最大的组为41 - 50岁，平均年龄为50.72岁。男性比例略高于女性。足部跖面共有22处（44%）溃疡。在整个研究中，37例（74%）个体报告有II级或III级神经病变，29例（58%）个体未报告糖尿病神经病变症状。研究中的大多数个体糖化血红蛋白（HbA1c）水平在6.5%至8%之间。干预后，44例（88%）患者在六个月后VPT分级未发生变化。
卡方检验结果表明，糖尿病发病年限或糖尿病治疗史类型对接受调查个体的VPT分级没有显著影响。然而，HbA1c水平较高的个体往往表现出更严重的VPT损伤。
定期监测VPT分级对于神经病变的早期诊断、追踪疾病进展以及评估干预效果至关重要。因此，我们建议所有糖尿病患者在常规糖尿病检查中定期进行生物感觉阈值测量，以帮助预防疾病进展以及截肢等并发症，并改善他们的整体生活质量。
