Peripheral sensorimotor neuropathy is a recognised complication of diabetes mellitus. The aim of this study was to determine the prevalence of sensory impairment in the hands of participants with diabetes, the agreement between two measurement tools for assessing hand sensation and the association between hand sensibility, age, glycaemic control and end-organ damage.
A total of 162 participants were recruited from hospital and community settings and divided into two cohorts based on a diagnosis of diabetes. Participants were tested for the presence of hand neuropathy using two sensory assessment procedures: Semmes-Weinstein monofilaments and the AsTexTM device. Medical records of participants with diabetes were accessed retrospectively to determine glycaemic control and diabetes complications.
A highly statistically significant association was found between neuropathy and diabetes status (P<0.001) on monofilament testing. In participants with diabetes, 63.4% satisfied the criteria for peripheral neuropathy on monofilament testing in the right hand, compared to 11.3% of participants without diabetes. Similarly, in the left hand 64.6% of participants with diabetes reached the threshold for neuropathy, compared to 8.8% in the group without diabetes. Age, male gender and diabetic retinopathy were associated with neuropathy. Glycaemic control was not associated with the development of monofilament diagnosed neuropathy or AsTexTM performance. The AsTexTM identified participants with diminished protective sensation on monofilament testing. There was no association between clinical markers of diabetes control and end-organ damage and AsTexTM performance.
This study demonstrates a relationship between diabetes and upper limb neuropathy. Age, male gender and retinopathy were associated with diminished hand sensation. Neuropthy was not found to be related to glycaemic control. The AsTexTM may have a role as a sensitive screening tool for the early identification of diabetes related neuropathy in the hands.