Sensory testing in type 2 diabetes: Insights into neuropathy and systemic complications

AimsSensory tests such as vibration perception threshold (VPT), monofilament, pinprick, and temperature sensation are used to detect diabetic peripheral neuropathy (DPN). This study examined associations between these tests and chronic diabetic complications in type 2 diabetes, focusing on the clinical relevance of VPT.MethodsIn this retrospective study, 652 patients with type 2 diabetes evaluated at a tertiary center (2014-2024) underwent standardized neurological assessments. Based on VPT, patients were categorized as normal (<16 V), borderline (16-24 V), or abnormal (≥25 V). Associations between sensory tests and retinopathy, nephropathy, ischemic heart disease (IHD), cerebrovascular disease (CeVD), and diabetic foot ulcer (DFU) were examined in cross-sectional and longitudinal analyses.ResultsAbnormal VPT was present in 31.3% of patients and was independently associated with all five complications after multivariable adjustment: IHD (OR: 2.15), CeVD (OR: 3.31), DFU (OR: 15.94), retinopathy (OR: 7.66), and nephropathy (OR: 2.56). Borderline VPT was also independently associated with several outcomes. In a longitudinal subset (n=221; median follow-up ∼5 years), abnormal VPT was associated with incident IHD, DFU, retinopathy, and nephropathy.ConclusionVPT showed strong associations with microvascular and macrovascular complications, supporting its role as a practical indicator of systemic disease burden in type 2 diabetes.