Diabetic neuropathy
Jump to navigation
Jump to search
Screening
The National Institute for Health and Clinical Excellence (NICE) has addressed screening and recommends annually:[1]
Physical examination of patients’ feet:
- testing of foot sensation using a 10 g monofilament or vibration
- palpation of foot pulses
- inspection of any foot deformity and footwear
Although NICE and others[2] have recommended monofilament testing, its role in the major randomized controlled trial is not clear.[3]
Monofilament testing for diabetic neuropathy using preferred testing locations colored green.[4]
If screening with the monofilament is done, a three site test of the plantar surfaces of the great toe, the third metatarsal, and the fifth metatarsalsis is adequate according to a systematic review[4] of studies[5].
- ↑ (2004) CG10 Type 2 diabetes - footcare. National Institute for Health and Clinical Excellence
- ↑ Singh N, Armstrong DG, Lipsky BA (2005). "Preventing foot ulcers in patients with diabetes.". JAMA 293 (2): 217-28. DOI:10.1001/jama.293.2.217. PMID 15644549. Research Blogging.
- ↑ Litzelman DK, Slemenda CW, Langefeld CD, Hays LM, Welch MA, Bild DE et al. (1993). "Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus. A randomized, controlled trial.". Ann Intern Med 119 (1): 36-41. PMID 8498761.
- ↑ 4.0 4.1 Feng Y, Schlösser FJ, Sumpio BE (2009). "The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy.". J Vasc Surg 50 (3): 675-82, 682.e1. DOI:10.1016/j.jvs.2009.05.017. PMID 19595541. Research Blogging.
- ↑ Smieja M, Hunt DL, Edelman D, Etchells E, Cornuz J, Simel DL (1999). "Clinical examination for the detection of protective sensation in the feet of diabetic patients. International Cooperative Group for Clinical Examination Research.". J Gen Intern Med 14 (7): 418-24. PMID 10417599. PMC PMC1496604.