Studies report that a thorough assessment of your feet can help you to identify the risks of diabetes. About 422 million people across the world are suffering from diabetes. It is characterized by a high level of sugar in the blood. Insulin produced by the living organism controls the level of sugar in the body. Insufficient production of insulin or inability of the body to use it commonly lead to the disease. Diabetes is usually of two types,
- Diabetes mellitus or Type-I
- Diabetes insipidness or Type-II
According to the World Health Organization (WHO), diabetes has been prevalent in the middle and low-income countries since the 1980s. The disease is reported to cause additional complications like,
- Lower limb ulceration
The last two cases are commonly seen in patients with diabetes.
A report by the International Diabetes Federation (IDF) states that about half of all the diabetic patients worldwide develop foot ulcers. Moreover, the report declares that nerve damage or neuropathy is a key contributor to the onset of diabetic foot ulcers. It affects between 20 to 50 percent of the diabetic patients.
Neuropathy affects the patients in two ways,
- It triggers painful symptoms in the patients’ legs
- It induces numbness in the lower limbs
The numbness of the limbs makes the feet insensitive to pain and rising temperature which renders the patients more susceptible to injuries. Nerve damage also slows down the healing of wounds which leads to serious infections, if not addressed on time.
A recent study says that foot deformities, joint issues, and foot perfusion are the common indicators of developing foot ulcers. The study was published in the Journal of Diabetes Care published by the American Diabetes Association (ADA).
The researchers examined about 750 diabetic veterans. They found that the patients with deformed toes and a history of laser photocoagulation have increased risks of developing foot ulcers. Other risk factors for foot ulcers included reduced skin oxygenation and foot perfusion.
Another study published in the same journal said that there are two ways of identifying the patients with high risks of diabetes-related food ulcers i.e.
- Neuropathy disability score
- Vibration perception threshold test
Foot pressure measurement tests are an alternative post-screening test in patients, researchers say.
In addition, a study conducted in 2009 revealed that the “Semmes Weinstein monofilament examination (SWME)” was an effective way to determine the risk of nerve damage. The study was published in the Journal of Vascular Surgery. For the study, the researchers analyzed more than 1,000 healthy patients. They found that SWME is up to 93 percent sensitive and up to 100 percent specific in identifying patients at risk of diabetes-related nerve damage.
Some of the most important components of foot examination highlighted by the ADA’s report are,
- Dermatological assessment
- Musculoskeletal assessment
- Neurological assessment
The first one focuses on the presence of ulcers and possible differences in temperature between the limbs. The second assessment focuses on the rigid foot deformities with increased plantar pressure. These deformities trigger the onset of ulceration. The third assessment helps determine the nerve damage in patients. Five simple tests are used for neurological assessment these include,
- 10-g monofilaments score
- 128-Hz tuning forks
- Pinprick sensation test
- Ankle reflex test
- Vibration perception threshold score