The Prediction of Diabetic Neuropathic Foot Ulceration Using Vibration Perception Thresholds: A prospective study
- Matthew J Young, MRCP,
- John L Breddy, BSC,
- Aristidis Veves, MD and
- Andrew J M Boulton, FRCP
- Manchester Diabetes Center, Manchester Royal Infirmary , Manchester
- Applied Statistics Research Unit, University of Kent Canterbury, U. K
- Address correspondence and reprint requests to AndrewJ. M. Boulton, FRCP, Department of Medicine, Manchester Royal Infirmary, M13 9WL Manchester, U. K.
Abstract
OBJECTIVE To assess the ability of vibration perception threshold (VPT) to predict the development of diabetic foot ulceration.
RESEARCH DESIGN AND 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.
- Received September 2, 1993.
- Accepted December 9, 1993.
- Copyright © 1994 by the American Diabetes Association
