Vibrotactile sense in median and ulnar nerve innervated fingers of men with Type 2 diabetes, normal or impaired glucose tolerance

• Published in: Diabetic medicine Vol. 25; no. 5; pp. 543 - 549
• Main Authors: Dahlin, L. B., Thrainsdottir, S., Cederlund, R., Thomsen, N. O. B., Eriksson, K. F., Rosén, I., Speidel, T., Sundqvist, G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2008; Blackwell
• Subjects: Aged; Biological and medical sciences; Clinical Medicine; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - physiopathology; Electrophysiology; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fingers - innervation; Fundamental and applied biological sciences. Psychology; Glucose Intolerance - diagnosis; Glucose Intolerance - physiopathology; Glucose Tolerance Test - methods; Humans; Klinisk medicin; Male; median nerve; Median Nerve - physiopathology; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; neuropathy; Predictive Value of Tests; Sensation Disorders - diagnosis; Sensation Disorders - physiopathology; Sensory Receptor Cells - physiology; Touch - physiology; Type 2 diabetes; ulnar nerve; Ulnar Nerve - physiopathology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Vibration; vibrotactile sense; Endocrinopathy; Type 2 diabetes; Human; Obesity; Nervous system diseases; Nutrition; Cubital nerve; Nutrition disorder; Finger; ulnar nerve; Metabolic diseases; Male; Neuropathy; vibrotactile sense; Normal; Median nerve; Adult; Impaired glucose tolerance; Endocrinology; Nutritional status
• ISSN: 0742-3071; 1464-5491; 1464-5491
• DOI: 10.1111/j.1464-5491.2008.02433.x

Aims  To investigate vibrotactile sense (large fibre neuropathy) at different frequencies in index and little fingers (median and ulnar nerves, respectively) of subjects with diabetes, or impaired (IGT) or normal glucose tolerance (NGT). Methods  Vibration thresholds (tactilometry at seven frequencies (8, 16, 32, 64, 125, 250 and 500 Hz)) and median nerve function (electrophysiology) were examined in men (age 73.4 ± 0.12 years; n = 58, mean ± sd) with persistent NGT (n = 28) or IGT (n = 7) or with Type 2 diabetes mellitus (T2DM) (n = 23) for > 15 years. Results  HbA1c was increased and vibrotactile sense (sensibility index) was impaired in index and little fingers in men with T2DM. Vibration thresholds were particularly increased at 16, 250 and 500 Hz in the little finger (ulnar nerve). T2DM subjects showed electrophysiological (gold standard) signs of neuropathy in the median nerve. Although subjects with persistent IGT had higher HbA1c, vibrotactile sensation and electrophysiology remained normal. HbA1c did not correlate with vibrotactile sense or electrophysiology, but the latter two correlated with respect to Z‐score (sign of neuropathy) in forearm (NGT) and at wrist level (NGT and DM). Conclusions  Vibration thresholds are increased in the finger pulps in T2DM subjects, particularly at specific frequencies in ulnar nerve innervated finger pulps. Neuropathy is not present in IGT. Tactilometry, with a multi‐frequency approach, is a sensitive technique to screen for large fibre neuropathy in T2DM. Frequency‐related changes may mirror dysfunction of various receptors.