Smartphone-based App to Assess Diabetic Peripheral Neuropathy
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Background
Diabetic peripheral neuropathy (DPN) affects approximately 50% of individuals with diabetes and is a risk factor for amputations. Unfortunately, foot exams and screening tools are inconsistent and miss early-stage nerve damage. A smartphone-based application that delivers controlled vibrations, records patient responses, and computes a vibration perception threshold (SVPT) may present an accessible, precise monitoring avenue. This study assesses the clinical relevance and precision of SVPTs as a nerve health metric in patients with diabetes.
Methods
We measured SVPTs in 71 patients with pre-diabetes or diabetes and compared their efficacy with tuning fork exams. We analyzed the correlation between SVPT and Rydel-Seiffer tuning fork (RSTF) scores, along with their relationship with clinical DPN markers such as hemoglobin A1c (HbA1c), age, and disease duration using multivariable linear regression.
Results
SVPTs moderately correlated with RSTF scores ( R s = −0.43, p = 0.0019). Among adults aged 50 to 69, SVPTs correlated significantly with clinical markers ( F (4, 29) = 4.76, p = 0.00447, Multiple R 2 = 0.396, Adjusted R 2 = 0.313, ɛ = 0.167). The interaction between age and HbA1c was positively associated with SVPTs ( β = 0.118, p = 0.001), while SVPTs were negatively associated with diabetes duration ( β = −0.098, p = 0.003).
Conclusions
We present a clinically relevant, patient-operated smartphone application for DPN monitoring, tested on patients with varying DPN risk. This novel platform has the potential to provide a precise, reliable, and accessible avenue for identifying individuals at risk of developing DPN complications, prior to overt clinical manifestation.
