Display options
Share it on

Diabetes Care. 2010 Dec;33(12):2635-41. doi: 10.2337/dc10-0616. Epub 2010 Sep 10.

Vibration perception threshold as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the DCCT/EDIC study.

Diabetes care

Catherine L Martin, Barbara H Waberski, Rodica Pop-Busui, Patricia A Cleary, Sarah Catton, James W Albers, Eva L Feldman, William H Herman,


  1. University of Michigan, Ann Arbor, Michigan, USA. [email protected]

PMID: 20833868 PMCID: PMC2992204 DOI: 10.2337/dc10-0616


OBJECTIVE: To describe the sensitivity, specificity, positive predictive value, and negative predictive value of vibration perception threshold (VPT) testing in subjects with type 1 diabetes relative to gold standard assessments of peripheral neuropathy.

RESEARCH DESIGN AND METHODS: VPT was determined in 1,177 adults with type 1 diabetes 13-14 years after participating in a study of intensive (INT) versus conventional (CONV) diabetes treatment. Abnormal VPT was defined by values exceeding 2.5 SD above age-specific normal values. Signs and symptoms of peripheral neuropathy were assessed and electrodiagnostic studies were performed to establish definite clinical neuropathy, abnormal nerve conduction, and confirmed clinical neuropathy (the presence of both definite clinical neuropathy and abnormal nerve conduction).

RESULTS: Thirty-seven percent of subjects had definite clinical neuropathy, 61% had abnormal nerve conduction, and 30% had confirmed clinical neuropathy. Abnormal VPT was more common among former CONV than among INT subjects (64 vs. 57%, P < 0.05) and was associated with older age. VPT was a sensitive measure of confirmed clinical neuropathy (87%) and of definite clinical neuropathy (80%) and a specific measure of abnormal nerve conduction (62%). Higher VPT cut points improved test sensitivity and lower cut points improved specificity. Areas under the receiver operating characteristic curves ranged from 0.71-0.83 and were higher for older than for younger subjects and highest for those with confirmed clinical neuropathy.

CONCLUSIONS: VPT was a sensitive measure of peripheral neuropathy. Future researchers may choose to select VPT cut points for defining abnormality based on the population studied and clinical outcome of interest.


  1. N Engl J Med. 1993 Sep 30;329(14):977-86 - PubMed
  2. Diabetes Care. 2007 Oct;30(10):2613-8 - PubMed
  3. Ann Neurol. 1995 Dec;38(6):869-80 - PubMed
  4. Diabetes Care. 1997 Sep;20(9):1360-2 - PubMed
  5. Diabetes Care. 1997 Sep;20(9):1448-53 - PubMed
  6. Diabetes Care. 1994 Jun;17(6):557-60 - PubMed
  7. Diabetologia. 2005 Mar;48(3):578-85 - PubMed
  8. Clin Chem. 1993 Apr;39(4):561-77 - PubMed
  9. Muscle Nerve. 1992 Dec;15(12):1334-9 - PubMed
  10. Diabetes Care. 2010 May;33(5):1090-6 - PubMed
  11. Diabetes Care. 1994 Nov;17(11):1281-9 - PubMed
  12. Diabetes Care. 2005 Apr;28(4):956-62 - PubMed
  13. Exp Clin Endocrinol Diabetes. 2008 Feb;116(2):135-8 - PubMed
  14. Diabetes Care. 1999 Jan;22(1):99-111 - PubMed
  15. Ann Intern Med. 1995 Apr 15;122(8):561-8 - PubMed
  16. Muscle Nerve. 2004 May;29(5):734-47 - PubMed
  17. Diabetes Care. 2009 Oct;32(10):1896-900 - PubMed
  18. Neurology. 1992 Sep;42(9):1823-5 - PubMed
  19. Diabet Med. 2002 Aug;19(8):661-6 - PubMed
  20. J Diabetes Complications. 1995 Jul-Sep;9(3):170-6 - PubMed
  21. Diabetes. 1988 Jul;37(7):1000-4 - PubMed

MeSH terms

Publication Types