Peripheral neuropathy is a common complication of diabetes and requires regular surveillance for signs to allow early intervention
Peripheral neuropathy complications include damage to the nerves (diabetes neuropathy) and damage to the large blood vessels that serve the limbs (peripheral arterial disease).
It can lead to disease of the foot in up to 50 per cent of all patients 1.
Neuropathy cannot be diagnosed through history alone; careful examination of feet for evidence of sensory loss and an assessment of the circulation should form part of annual review for patients.
Supporting people with diabetes to stay well requires a range of interventions relating to their feet. These include maintenance of good control but also good self-care and screening.
Use of education
A Cochrane systematic review has found that currently no research to support the use of education alone to prevent foot ulceration and amputations. However, because diabetes has enormous and growing effects on individuals, increasing patient awareness of the implications of not caring for their feet must be part of educational packages and within all nurses’ health promotion role.
The Foot Risk Awareness and Management Education (FRAME) project was commissioned by the Scottish Government to produce an e-learning resource which would help standardise diabetes foot screenings performed by health care professionals.
Ipswich Touch Test
For self-assessment, The Ipswich Touch Test - screening for neuropathy at home involves relatives and friends examining the feet of diabetes patients using the Ipswich Touch test based on written instructions. Evaluation has shown there is a strong concordance with examinations carried out by healthcare professionals.
- Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28:956-962.