Screening tools for diabetic foot ulcers: a narrative review

Area of Science:

• Podiatry
• Diabetology
• Neurology

Background:

• Diabetic foot ulcers (DFUs) affect 4-10% of individuals with diabetes mellitus.
• DFUs lead to significant morbidity, mortality, reduced quality of life, and high healthcare costs.
• Key risk factors include diabetic neuropathy, peripheral arterial disease, and trauma.

Purpose of the Study:

• To determine if somatic nerve function tests predict DFU development.
• To assess sudomotor function screening tests for DFU screening.
• To evaluate other tests like plantar pressure and temperature measurements for DFU risk assessment.

Main Methods:

• Evaluated tests of somatic nerve function: pinprick sensation, thermal tests, ankle reflexes, vibration perception, 10-g monofilament, Ipswich touch test, neuropathy disability score, nerve conduction studies.
• Examined sudomotor function tests: Neuropad, sympathetic skin response.
• Assessed other tests: elevated plantar pressure, temperature measurements.

Main Results:

• Somatic nerve function tests, including vibration perception and monofilament testing, are crucial for predicting DFU risk.
• Sudomotor tests like Neuropad also show potential in DFU screening.
• Combined assessment of multiple tests improves prediction accuracy.

Conclusions:

• Early identification of patients at risk for DFUs is vital for preventing severe outcomes.
• A comprehensive screening approach utilizing both nerve function and sudomotor tests is recommended.
• Timely intervention based on screening results can reduce DFU incidence and associated complications.