The prediction of diabetic neuropathic foot ulceration using vibration perception thresholds. A prospective study.
OBJECTIVE
To assess the ability of vibration perception threshold (VPT) to predict the development of diabetic foot ulceration.


METHODS
A prospective follow-up study of consecutive patients with vibration perception measured by biothesiometry from April 1988 to March 1989. Patients were stratified in various risk groups.


RESULTS
Patients with a VPT < 15 V had a cumulative incidence of foot ulceration of 2.9% compared with 19.8% in patients with a VPT > 25 V, odds ratio (OR) 7.99 (3.65-17.5, 95% confidence intervals), P < 0.01. The incidence of ulceration increased with duration of diabetes, but even with this effect removed, the excess of ulceration persisted, OR 6.82 (2.75-16.92), P < 0.01.


CONCLUSIONS
VPT is an effective predictor of the risk of foot ulceration in diabetes and therefore could be used to target foot-care education to those patients most likely to benefit and, thereby, possibly improve its effectiveness.
Young
M J
MJ
Manchester Diabetes Center, U.K.
Breddy
J L
JL
Veves
A
A
Boulton
A J
AJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001824:Body Constitution; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010465:Perception; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014732:Vibration