The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

Παπάνας, Νικόλαος; Pafili, Kalliopi; Δημητρίου, Μαρία; Papachristou, Stella; Kyroglou, Soultana; Papazoglou, Dimitrios; Maltezos, Efstratios

doi:10.1007/s13300-019-00738-4

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…Diabetic peripheral neuropathic pain (DPNP) affects around 26% of persons with diabetes and is present in approximately one-third of DSPN patients [ 7 ], impairing their ability to perform activities of daily living and affecting their mental quality of life [ 8 ]. With the goal of improving the diagnosis and screening of DSPN in patients with type 2 DM, new tests have been developed, and risk factors have been investigated in recent years [ 9 – 11 ]. However, the correlation of DM and diabetic peripheral neuropathy is complicated, and diagnosis standards and risk factors vary between studies.…”

Section: Introductionmentioning

confidence: 99%

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

Weng

Tsai

Lyu

et al. 2020

Journal of Diabetes Research

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This cross-sectional study is aimed at determining the prevalence of distal symmetrical polyneuropathy (DSPN) and diabetic peripheral neuropathic pain (DPNP) in participants with type 2 diabetes mellitus (T2DM); finding the risk factors for DSPN and DPNP via biochemical tests; and correlating DSPN and DPNP with the results of electrophysiologic studies, quantitative sensory tests, and neurologic examination. The 145 participants with T2DM enrolled were divided into the DSPN (abnormal nerve conduction studies (NCS) with signs of polyneuropathy), subclinical DSPN (abnormal NCS without signs of polyneuropathy), minimal DSPN (normal NCS with signs of polyneuropathy), and no DSPN groups. The biochemical risk factors of diabetic peripheral neuropathy were investigated. Neurologic examinations, laboratory tests, NCS, vibration threshold tests, and thermal threshold tests were conducted. The modified Michigan Neuropathy Screening Instrument (mMNSI) and Douleur Neuropathique 4 were used to evaluate the severity of DSPN and DPNP, respectively. In all, 30% of participants had DSPN and 11% had DPNP. DSPN correlated strongly with male gender and higher glycohaemoglobin levels; NCS abnormality correlated with higher glycohaemoglobin levels; DSPN severity correlated with NCS of each stimulating nerve. DPNP commonly occurred with clinical and electrophysiologic evidence of DSPN. Symptomatic diabetic polyneuropathy significantly correlated with longer disease duration, higher glycohaemoglobin levels, and abnormal vibration tests. The thermal threshold test combined with nerve conduction tests could detect most of the patients with DSPN, subclinical DSPN, and minimal DSPN. Poor diabetic control was independently associated with the development of DSPN. DPNP was associated with DSPN. The combination of thermal threshold tests with NCS can potentially provide the diagnosis of DSPN.

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Section: Introductionmentioning

confidence: 99%

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

Weng

Tsai

Lyu

et al. 2020

Journal of Diabetes Research

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“…The study showed that when VibraTip was compared with NDS ≥ 3, it had 0.91 and 0.96 sensitivity, 0.85 and 0.91 specificity, 0.84 and 0.90 PPV, 0.92 and 0.96 NPV, 6.2 and 10.3 +LR, 0.1 and 0.05 −LR in the 2 protocols, respectively. 9 Although we evaluated the accuracy of VibraTip for the assessment of LOPS and not DSPN, we also found similar diagnostic performance. The differences between the diagnostic accuracy of VibraTip in each study can be explained from the difference reference method used.…”

Section: Discussionmentioning

confidence: 62%

“…The latter study also compared VibraTip with a NDS ≥ 6 and found that VibraTip had 1.00 sensitivity, 0.90 specificity, 0.95 PPV, 1.00 NPV, 10.3 +LR, and 0 −LR. 8 Last but not least, a recently published study by Papanas et al 9 examined the performance of VibraTip for the diagnosis of DSPN in comparison with NDS ≥ 3 and NDS ≥ 6 using 2 different examination protocols for the VibraTip. The study showed that when VibraTip was compared with NDS ≥ 3, it had 0.91 and 0.96 sensitivity, 0.85 and 0.91 specificity, 0.84 and 0.90 PPV, 0.92 and 0.96 NPV, 6.2 and 10.3 +LR, 0.1 and 0.05 −LR in the 2 protocols, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…16 Three previous well-designed studies examined the performance of VibraTip for the diagnosis of DSPN. [7][8][9] Bracewell et al 7 showed that when the neurothesiometer was used as the reference method for the assessment of DSPN (failure to perceive stimulus ≥25 V in either foot), VibraTip had 0.79 sensitivity, 0.82 specificity, 0.75 PPV, 0.85 NPV, 4.39 +LR, and 0.25 −LR. Another study by Bowling et al, 8 which also used the neurothesiometer as the reference method, showed that VibraTip had 1.00 sensitivity, 0.97 specificity, 0.98 PPV, 1.00 NPV, 0.29 +LR, and 0 −LR for the diagnosis of DSPN.…”

Section: Discussionmentioning

confidence: 99%

“…5 Previous studies have shown that the VibraTip has good accuracy for the diagnosis of DSPN compared with the neurothesiometer and the neuropathy disability score (NDS). [7][8][9] Nevertheless, so far, the VibraTip has not been compared with the 10-g monofilament, which is widely used in primary care setting for the assessment of foot insensation. In addition, there is lack of data regarding the agreement between different community health care professionals who participate in the management of people with diabetes for the assessment of LOPS using 3 different tools, the 10-g monofilament, the 128-Hz tuning fork, and the VibraTip.…”

Section: Introductionmentioning

confidence: 99%

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The Performance and Interrater Agreement of Vibration Perception for the Diagnosis of Loss of Protective Sensation in People With Diabetes Mellitus

Tentolouris

Eleftheriadou

et al. 2021

The International Journal of Lower Extremity Wounds

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This study examined the performance of VibraTip for the diagnosis of loss of protective sensation (LOPS) and the interrater agreement of different neurological modalities performed by 3 health care professionals, a consultant diabetologist, a diabetes specialist nurse, and a podiatrist. Diagnosis of LOPS was based on 10-g Semmes Weinstein monofilament testing performed by a consultant diabetologist (reference method), while examination with a 128-Hz tuning form was also performed. The performance of VibraTip for the diagnosis of LOPS was examined using the receiver operating characteristic curves analysis. Interrater agreement was determined by weighted kappa (κ) statistics. Diagnosis of LOPS (%) was 37.5%. Receiver operating characteristic curve analysis showed that VibraTip examination versus 10-g monofilament, both performed by a consultant, could diagnose LOPS ( P < .001). Sensitivity, specificity, positive predictive value, and negative predictive value of VibraTip versus 10-g monofilament, both performed by a consultant (value, 95% confidence interval), was 0.705 (0.591-0.803), 0.836 (0.758-0.897), 0.733 (0.642-0.808), and 0.816 (0.757-0.863), respectively. The interrater agreement among the health care professionals for 10-g monofilament, VibraTip, and 128-Hz tuning fork in neurological assessment was good with κ > 0.61. VibraTip can be used as a screening tool for the detection of LOPS. There was good overall agreement in the results of neurological examination using 10-g monofilament, 128-Hz tuning fork, and VibraTip among health care professionals.

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Large Fiber Neuropathy

Vijayan,

Lim

2025

International Encyclopedia of Public Health

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The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

Cited by 8 publications

References 18 publications

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

The Performance and Interrater Agreement of Vibration Perception for the Diagnosis of Loss of Protective Sensation in People With Diabetes Mellitus

Large Fiber Neuropathy

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