Tentolouris Anastasios, Stergioti Anastasia, Eleftheriadou Ioanna, Siafarikas Christos, Tsilingiris Dimitrios
First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 17 Agiou Thoma Street, Athens, 11527, Greece.
First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thracae, Dragana, Alexandroupolis, 68100, Greece.
Hormones (Athens). 2025 Mar;24(1):71-83. doi: 10.1007/s42000-024-00598-z. Epub 2024 Sep 4.
The prevalence of diabetic foot ulcers (DFUs) is 4 to 10% among people with diabetes mellitus. DFUs are associated with increased morbidity and mortality as well as reduced quality of life and have a significant impact on overall healthcare expenditure. The main predisposing factors for DFU are diabetic neuropathy, peripheral arterial disease, and trauma. The fact that a range of tests can be used to identify patients at risk for DFU often causes confusion among practitioners regarding which screening tests should be implemented in clinical practice. Herein we sought to determine whether tests of somatic nerve function, such as pinprick sensation, thermal (cold/hot) test, ankle reflexes, vibration perception, 10-g monofilament, Ipswich touch test, neuropathy disability score, and nerve conduction studies, predict the development of DFUs. In addition, we examined whether sudomotor function screening tests, such as Neuropad, sympathetic skin response, and other tests, such as elevated plantar pressure or temperature measurements, can be used for DFU screening. If not treated properly, DFUs can have serious consequences, including amputation, early detection and treatment are vital for patient outcomes.
糖尿病足溃疡（DFU）在糖尿病患者中的患病率为4%至10%。DFU与发病率和死亡率增加、生活质量下降相关，对总体医疗支出有重大影响。DFU的主要诱发因素是糖尿病神经病变、外周动脉疾病和创伤。一系列检查可用于识别有DFU风险的患者，这一事实常常让从业者在临床实践中对应实施哪些筛查检查感到困惑。在此，我们试图确定躯体神经功能检查，如针刺觉、温度（冷/热）测试、踝反射、振动觉、10克单丝、伊普斯威奇触觉测试、神经病变残疾评分和神经传导研究，是否能预测DFU的发生。此外，我们还研究了诸如神经垫、交感神经皮肤反应等泌汗功能筛查测试，以及诸如足底压力升高或温度测量等其他测试，是否可用于DFU筛查。如果治疗不当，DFU可能会产生严重后果，包括截肢，早期检测和治疗对患者的预后至关重要。
