title: Disturbed vibrotactile sense in finger pulps in patients with Type 1 diabetes--correlations with glycaemic level, clinical examination and electrophysiology.
abstract: OBJECTIVE
  In a cohort of men and women with Type 1 diabetes, prospectively followed for > 20 years, vibrotactile sense in fingers was investigated and related to neurophysiological tests, glycaemic level and clinical score.
  
  
  METHODS
  Out of 58 patients, diagnosed at the age of 15-25 years and recruited 1984-1985, 32 patients (13 women, median age 52 years, range 44-75 years; 19 men, median age 52 years, range 39-69 years; median duration 33.5 years, range 21-52 years) accepted follow-up in 2006. Vibration thresholds were measured in finger pulps of index and little fingers bilaterally at seven frequencies and related to results of touch (monofilaments), tactile discrimination (two-point discrimination test), electrophysiology (median nerve function), glycaemic level (HbA(1c) levels since 1984-1985) and a clinical score.
  
  
  RESULTS
  Vibrotactile sense was reduced in finger pulps, mainly in men, compared with an age- and gender-matched healthy control group with normal HbA(1c) . Vibration thresholds were increased, particularly at 250 and 500 Hz, in both index and little finger pulps. Touch and tactile discrimination correlated with vibration thresholds, but not with each other or with electrophysiology. HbA(1c) levels (at follow-up or mean values from five follow-ups since recruitment) did not correlate with any nerve function variables. Clinical scores correlated with vibrotactile sense, particularly at higher frequencies (> 125 Hz), but not with total Z-scores of electrophysiology. Duration of disease did not correlate with any variables.
  
  
  CONCLUSIONS
  Examination of vibration thresholds in index and little finger pulps may be valuable to detect neuropathy, where thresholds correlate with symptoms and tests.
authors.affiliation: Department of Hand Surgery , Skåne University Hospital, Malmö, Sweden. Lars.Dahlin@med.lu.se
authors.forename: L B
authors.initials: LB
authors.lastname: Dahlin
authors.forename: V
authors.initials: V
authors.lastname: Granberg
authors.forename: O
authors.initials: O
authors.lastname: Rolandsson
authors.forename: I
authors.initials: I
authors.lastname: Rosén
authors.forename: E
authors.initials: E
authors.lastname: Dahlin
authors.forename: G
authors.initials: G
authors.lastname: Sundkvist
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology*; D004594:Electrophysiology; D005260:Female; D005385:Fingers / Q000294:innervation / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012678:Sensation Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014732:Vibration; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human