Reversal of diabetic peripheral neuropathy and new wound incidence: the role of MIRE

Adv Skin Wound Care. Jul-Aug 2004;17(6):295-300. doi: 10.1097/00129334-200407000-00012.

Abstract

Objective: To determine if improved foot sensitivity to the Semmes-Weinstein 10-g (5.07) monofilament, originally impaired because of diabetic peripheral neuropathy, might be associated with a reduced incidence of new diabetic foot wounds.

Design: Retrospective cohort study using a health status questionnaire.

Subjects: Sixty-eight individuals over age 64 with diabetes, diabetic peripheral neuropathy, and loss of protective sensation who had clinically demonstrable increases in foot sensation to the Semmes-Weinstein monofilament after treatment with monochromatic near infrared photo energy.

Main results: After reversal of diabetic peripheral neuropathy following treatment with monochromatic near infrared photo energy, only 1 of 68 patients developed a new diabetic foot wound, for an incidence of 1.5%. Comparatively, the incidence previously reported in the Medicare-aged population with diabetes was 7.3%.

Conclusions: Improved foot sensitivity to the Semmes-Weinstein monofilament in patients previously suffering from loss of protective sensation due to diabetic neuropathy appears to be associated with a lower incidence of new diabetic foot ulcers when compared with the expected incidence in the Medicare-aged population with diabetes.

Clinical relevance: Therapeutic interventions that effectively improve foot sensitivity that has been previously diminished due to diabetic peripheral neuropathy may substantially reduce the incidence of new foot wounds in the Medicare-aged population with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diabetic Foot / epidemiology
  • Diabetic Foot / physiopathology
  • Diabetic Foot / prevention & control*
  • Disease Progression
  • Female
  • Florida / epidemiology
  • Health Status
  • Humans
  • Incidence
  • Male
  • Medicare
  • Middle Aged
  • Neurologic Examination / instrumentation
  • Neurologic Examination / methods
  • Prevalence
  • Recurrence
  • Retrospective Studies
  • Sensation
  • Severity of Illness Index
  • Spectroscopy, Near-Infrared / methods*
  • Spectroscopy, Near-Infrared / standards
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Wound Healing