Testing for Diabetic Neuropathy
Diabetic neuropathy is a condition that affects up to half of all patients living with diabetes. In order to identify potential loss of sensation from neuropathy, proper and regular testing should be completed routinely in diabetic foot care patients.
The potential complications resulting from diabetic neuropathy can be devastating. Currently, the number one cause of foot and leg amputations in diabetic patients result from non-healing wounds that started as ulcerations following minor unnoticed injuries.
Make regular neuropathy testing an integral part of your foot care practice and educate your patients accordingly. While there are a wide variety of guidelines diabetic patients should ideally follow in order to prevent ulcerations from injuries, we understand that overwhelmed patients are less likely to comply with any instructions at all.
To keep things simple, use these easy-to-remember guidelines for diabetic foot care patients.
1. Examine feet regularly
2. Alert others of a problem
3. Follow nurse guidelines
2. Use at-home callus removers
3. Wear constricting shoes
In your practice, you may use a monofilament test, a tuning fork test or both to identify neuropathy in a timely manner. Below, we will discuss each.
Semmes-Weinstein Monofilament Test
This test is designed to deliver direct force to one area of the foot at a time in order to find areas in which numbness most frequently occurs. Monofilaments are affordable and come in disposable or reusable products.
The monofilament test may be inadequate for determining loss of sensation at the first stages of neuropathy.
1. Place monofilament perpendicular to the skin
2. Apply pressure until the monofilament buckles
3. Hold and release
For additional information, including video instructions about how to use this product, use the following link.
Tuning Fork Test
This test sends vibrations throughout the patient's foot to determine if and where loss of sensation has occurred. It can detect neuropathy at an earlier stage than a Semmes-Weinstein test.
1.Tap the tuning fork to create vibration
2.Apply base of the tuning fork to a bone on the tip of the great toe
3.Ask the patient to tell you where the vibration stops
4.Confirm with your own hand whether vibration does stop there
For more information about this test or to purchase a tuning fork, use the following link.