Preventing diabetes-related foot ulcers through early detection of peripheral neuropathy

Aust J Gen Pract. 2022 Nov;51(11):833-838. doi: 10.31128/AJGP-06-22-6456.

Abstract

Background: Peripheral neuropathy, peripheral arterial disease and diabetes-related foot ulcers are the most important risk factors for future amputation. Up to 50% of people with diabetes have distal symmetrical polyneuropathy as a complication of diabetes. Distal symmetrical polyneuropathy results in loss of protective sensation in the feet, increasing the risk of diabetes-related foot ulceration.

Objective: The aim of this article is to provide structured guidance for detecting diabetes-related peripheral neuropathy, appropriate referral based on risk assessment and prevention of diabetes‑related foot ulceration.

Discussion: As a result of the often-asymptomatic nature of diabetes-related peripheral neuropathy, general practice is an ideal location for screening all adults with diabetes for loss of protective sensation. Loss of protective sensation in a person with diabetes indicates an at-risk foot. Increased frequency of foot examination, education in self-care, appropriate footwear and referral to podiatry for non‑ulcerative foot problems can reduce the development of diabetes-related foot ulcers.

MeSH terms

  • Adult
  • Amputation, Surgical / adverse effects
  • Diabetes Mellitus*
  • Diabetic Foot* / diagnosis
  • Diabetic Foot* / prevention & control
  • Diabetic Neuropathies* / complications
  • Diabetic Neuropathies* / diagnosis
  • Diabetic Neuropathies* / prevention & control
  • Foot Ulcer*
  • Humans
  • Polyneuropathies* / complications