Detection of diabetic peripheral neuropathy from index finger using vibration mechanism.

Objective: Diabetic Peripheral Neuropathy (DPN) is the most common prolonged complication of diabetes. A nerve reaches to the hands, legs, and a foot is damaged due to excessive glucose level. This leads to the loss of sensation, numbness and pain in the feet, legs or hands. Currently available devices are expensive, take more time and need more expertise to operate them to detect the level of DPN. This study is designed to detect the level of diabetic peripheral neuropathy (DPN) from first joint of index finger using a novel 128-Hz electronic tuning fork prototype which is capable of performing accurate vibration perception duration (VPD). Methods: A total of 169 diabetic patients were recruited from the secondary author's practice for assessment of level of DPN with our device. All the patients were enrolled according to an approved protocol. Patient places index finger on the tip of our device in such a way that the tip covers the first joint of index finger. Our device then provides the vibration of desired frequency and voltage to the index finger via tactile platform and patient starts feeling the vibration. Depending on the vibration perception duration (VPD) for which the patient feels the vibration, 4 levels of DPN i.e. Normal, Mild, Moderate and Severe are calculated. Three repeated measurements were taken from all 169 patients. Results: Our device detected 74 DPN patients (6 severe, 26 moderates, 42 mild) and 89 normal (no DPN) patients. The mean of vibration perception duration (VPD) was 6.8 s, with a standard deviation (SD) of ± 0.84 s of all 169 patients. Mean VPD of severe, moderate, mild and normal level of DPN patients was 1.73 (mean SD = 0.7 s), 5.82 (mean SD = 0.84 s), 8.32 (mean SD = 1 s) and 11.3 s (mean SD = 0.84 s), respectively. Considering the Biothesiometer as the reference standard, our results were compared against it and our device's result accuracy was > 92%. Conclusion: VPD was a sensitive measure of a detection of level of DPN. The device is compact, handy, easy to use and takes only few seconds to diagnose the level of DPN level in diabetic patients.