The vibratory perception threshold in young diabetic patients: associations with glycemia and puberty

The vibratory perception threshold, an indicator of sensory neuropathy, was measured in young type I diabetic patients (N = 55) and nondiabetic control subjects (N = 34) of similar age. Values were significantly higher in the diabetic patients (P less than 0.01), and 20% had values greater than that of any control subject. This difference was most marked among those postpubertal and persisted with allowances for age and gender in an analysis of covariance. Although the vibratory perception threshold was not related to hemoglobin A1 in younger diabetic patients (Tanner stage less than 5), there was a highly significant positive relationship in postpubertal patients (r = 0.72, P less than 0.001). There were also associations of the vibratory perception threshold with age in diabetic and control subjects (r = 0.44 and r = 0.43, respectively, P less than 0.01 for both) and with diabetes duration (r = 0.36, P less than 0.01). These data indicate that vibratory perception threshold abnormalities occur early in the course of type I diabetes mellitus; however, they are more evident in those patients who are postpubertal. In addition, they suggest that the association between the vibratory perception threshold and glycemia may be modified by developmental factors.