Vibration Perception Threshold Changes Following Integrated Care forDiabetic Peripheral Neuropathy: A Case Report.

Abstract

Diabetic peripheral neuropathy (DPN) is a common microvascular complication of diabetes mellitus characterized by sensory loss, pain, and foot ulceration. This case report evaluates longitudinal changes in vibration perception threshold (VPT) and glycaemic parameters in a 65-year-old man with long-standing type 2 diabetes mellitus presenting with bilateral lower extremity pain and plantar burning sensations.  At baseline, HbA1c was 9.8%, and biothesiometry measured VPT values of 32.48 V (right) and 30.12 V (left), classified as severe impairment, alongside preserved 10-gram monofilament responses. The patient received a one-month programme of dietary glycaemic management, supervised warm water foot immersion, and plantar acupressure. At one month, VPT decreased to 24.35 V and 23.33 V in the right and left feet, respectively, and remained in the moderate range at subsequent assessments. HbA1c was 8.2% at final follow-up. These findings suggest a temporal correlation between the integrated protocol and objective improvements in neuropathy metrics.