Diabetic neuropathy is one of most important factors for foot ulceration in diabetes mellitus (DM) patients.
Among different sensibility measures of neuropathy, two-point discrimination (TPD) has been suggested as a reliable method; however,
the correlation of TPD with other well-known measures is not known. We measured the loss of protective sensation using
Semmes-Weinstein monofilaments (SWMF), hardness of the foot sole using Shore meter, power ratio (PR) using Pedopowergraph,
and TPD using Aesthesiometer in foot areas of both left and right legs in 14 DM subjects with 5-20 years of the disease.
All the subjects were clinically screened for peripheral artery occlusive disease (PAOD). There were no subjects with clinical
vasculopathy. We have found no correlation between TPD and shore values and also no correlation between TPD and power ratio.
The SWMF (10gm) is found not to provide any additional value in measuring loss of sensation in comparison to TPD.
TPD appears to be measuring different property of the foot compared to the other measures. The mechanism of this independence
is not well understood and warrants further investigation.
- R. Periyasamy, M.Manivannan, V.B.Narayanamurthy, "Correlation between Two Point Discrimination with other measures of Sensory loss in Diabetic Mellitus Patients", Communicated to International Journal of Diabetes in Developing Countries 2008.