Early detection of altered cold perception in elderly with type 2 diabetes using a novel Quantitative Sensory Testing method

Aim

To compare the effectiveness of two methods for measuring cold detection thresholds in screening for temperature-perception deficits in elderly individuals with type 2 diabetes (T2 diabetes).

Methods

Cold threshold measurements were performed on seven body regions of participants with diabetes without neuropathy (n = 30; mean age, 70.9 ± 6.5 years) and healthy participants (n = 73; mean age, 68 ± 5 years). Two protocols applying the Levels Method were used: the first used skin temperature as the starting point; the second used 40 °C.

Results

Cold detection thresholds were significantly higher in subjects with diabetes, particularly on the foot. For CDT TSk, values were −2.22 ± 1.91 °C in non-diabetic and −3.27 ± 3.33 °C in diabetic groups (p = 0.023); for CDT 40, values were −9.82 ± 3.5 °C and −12.18 ± 4.5 °C (p = 0.003). However, after adjusting for age, the group effect on cold threshold with skin temperature as baseline disappeared. Sensory screens showed that the Area Under Curve of the method using a 40 °C baseline was 0.69 (p = 0.002).

Conclusion

Measuring the cold detection threshold on the foot with a 40 °C baseline is more effective than using skin temperature as a baseline for screening sensory alterations in elderly subjects with type 2 diabetes before neuropathy onset.

Significance

These findings highlight the importance of selecting the appropriate cold detection threshold method for elderly individuals with type 2 diabetes. The optimal method can facilitate early identification of sensory changes, minimizing complications and improving overall well-being.