Vibratory and thermal thresholds in diabetics with and without clinical neuropathy

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Abstract
Vibration and thermal detection threshold and heat pain threshold were determined in 34 diabetics scrutinized for clinical neuropathy using a standardized questionaire and examination form. On the basis of the clinical grading patients were classified as having either no neuropathy or a neuropathy of increasing severity. As expected thermal and vibratory detection threshold increased with increasing severity of neuropathy. Comparison between diabetics without symptoms and signs of neuropathy and a corresponding non‐diabetic control group showed that a warm sensibility index (WSI = the range in which non‐noxious heat is perceived) was significantly lower on feet in diabetics than in their matched non‐diabetic controls. The findings show that quantitative assessment of thermal sensitivity may be of value to detect early small nerve fiber dysfunction even in patients without symptoms or signs of a clinical neuropathy.

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