A review of the current evidence on the sensitivity and specificity of the Ipswich touch test for the screening of loss of protective sensation in patients with diabetes mellitus

Hu, Arnold; Koh, B. T. H.; Teo, Melissa Raye

doi:10.1007/s13340-020-00451-9

Cited by 13 publications

(4 citation statements)

References 20 publications

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“…Sensitivity assessment points are placed at the tips of the first, third, and fifth toes of both feet, and the other two sites are the dorsum of both halluces. IpTT, compared to the 10 g monofilament and the vibration perception test, has shown good sensitivity and specificity, ranging from 51 to 100% and 90 to 98%, respectively [ 97 ].…”

Section: Diagnosismentioning

confidence: 99%

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Galiero

Caturano

Vetrano

et al. 2023

IJMS

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Diabetic neuropathy (DN) is one of the main microvascular complications of both type 1 and type 2 diabetes mellitus. Sometimes, this could already be present at the time of diagnosis for type 2 diabetes mellitus (T2DM), while it appears in subjects with type 1 diabetes mellitus (T1DM) almost 10 years after the onset of the disease. The impairment can involve both somatic fibers of the peripheral nervous system, with sensory-motor manifestations, as well as the autonomic system, with neurovegetative multiorgan manifestations through an impairment of sympathetic/parasympathetic conduction. It seems that, both indirectly and directly, the hyperglycemic state and oxygen delivery reduction through the vasa nervorum can determine inflammatory damage, which in turn is responsible for the alteration of the activity of the nerves. The symptoms and signs are therefore various, although symmetrical painful somatic neuropathy at the level of the lower limbs seems the most frequent manifestation. The pathophysiological aspects underlying the onset and progression of DN are not entirely clear. The purpose of this review is to shed light on the most recent discoveries in the pathophysiological and diagnostic fields concerning this complex and frequent complication of diabetes mellitus.

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Section: Diagnosismentioning

confidence: 99%

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Galiero

Caturano

Vetrano

et al. 2023

IJMS

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“…Based on current guidelines, there are several criteria for stratifying patients according to their clinical risk for Patients at increased risk for DFS and lower-extremity amputation are recommended to undergo SWME, despite concerns about diagnostic accuracy of SWME during screening for diabetes-related foot disease [104][105][106][107] and questions about the number of sites on the foot that must be assessed [106,107]. In settings where SWME cannot be conducted, the Ipswich Touch Test (IpTT) is a potential substitute assessment that may be used to evaluate LOPS [108][109][110]. However, since no clinical guidelines currently recommend IpTT for risk stratification, more studies are needed to evaluate whether it is an appropriate substitute for SWME.…”

Section: Principle 2: Risk Stratificationmentioning

confidence: 99%

Screening for diabetic peripheral neuropathy in resource-limited settings

Nkonge

2023

Diabetol Metab Syndr

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Background Diabetic neuropathy is the most common microvascular complication of diabetes mellitus and a major risk factor for diabetes-related lower-extremity complications. Diffuse neuropathy is the most frequently encountered pattern of neurological dysfunction and presents clinically as distal symmetrical sensorimotor polyneuropathy. Due to the increasing public health significance of diabetes mellitus and its complications, screening for diabetic peripheral neuropathy is essential. Consequently, a review of the principles that guide screening practices, especially in resource-limited clinical settings, is urgently needed. Main body Numerous evidence-based assessments are used to detect diabetic peripheral neuropathy. In accordance with current guideline recommendations from the American Diabetes Association, International Diabetes Federation, International Working Group on the Diabetic Foot, and National Institute for Health and Care Excellence, a screening algorithm for diabetic peripheral neuropathy based on multiphasic clinical assessment, stratification according to risk of developing diabetic foot syndrome, individualized treatment, and scheduled follow-up is suggested for use in resource-limited settings. Conclusions Screening for diabetic peripheral neuropathy in resource-limited settings requires a practical and comprehensive approach in order to promptly identify affected individuals. The principles of screening for diabetic peripheral neuropathy are: multiphasic approach, risk stratification, individualized treatment, and scheduled follow-up. Regular screening for diabetes-related foot disease using simple clinical assessments may improve patient outcomes.

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“…If this is not available, an Ipswich test is a reasonable substitute. This test consists of lightly touching the plantar aspect of digits 1, 3, and 5 for 1–2 s. In a metanalysis review of 5 papers, when compared to 10 g monofilament, the sensitivity of the Ipswich test ranged from 51% to 83%, and the specificity range was 96.4%–98% [91].…”

Section: The Magnitude Of Cardiometabolic Risks In the Uaementioning

confidence: 99%

Cardiometabolic Guidelines: Cardiovascular Risk Assessment and Management in Patients with Dysglycemia

Hassanein,

Sabbour,

Al Awadi

et al. 2023

Dubai Diabetes Endocrinol J

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Background: Cardiovascular diseases (CVDs) are the major cause of mortality and disability in patients with type 2 diabetes mellitus (T2DM). The increased risk of major cardiovascular (CV) events in patients with T2DM causes an estimated 12-year reduction in life expectancy. Despite their heightened CV risks, most T2DM patients do not meet treatment targets for multiple CV risk factors. Moreover, in the UAE, the incidence of cardiometabolic diseases is exceedingly high, impacting young patients and leading to a high burden of premature CV events. Summary: We propose this comprehensive cardiometabolic evaluation to address both glycemic control and early diagnosis of CV complications as well as early implementation of multifactorial intensive therapies that are evidence and guideline based. Widespread utilization and implementation of the guidelines in primary diabetic care, coupled with early referral to a CV or the relevant specialists, will result in a significant reduction of CV events and CV hospitalization in the UAE population. Hence, the Emirates Diabetes and Endocrine Society with the Emirates Cardiac Society collaborated for the first time to develop these recommendations. These will aid in the early identification of CV risk factors in persons with prediabetes and diabetes, as well as their effective assessment and management. These guidelines are aimed not just at primary care physicians but also specialists, perhaps leading to a more collaborative and multidisciplinary approach to the prevention, diagnosis, and treatment of patients with diabetes and CVD. Key Message: The establishment of combined cardiometabolic clinics providing comprehensive assessment and management in every major cardiology and diabetology center, particularly in patients who have already had a CV event, where the combined involvement of a cardiologist and a diabetologist in an intensive multifactorial outpatient program is urgently required to prevent recurrent CV events. In addition, establishing a National Cardiometabolic Registry is an essential element of this recommendation.

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A review of the current evidence on the sensitivity and specificity of the Ipswich touch test for the screening of loss of protective sensation in patients with diabetes mellitus

Cited by 13 publications

References 20 publications

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Screening for diabetic peripheral neuropathy in resource-limited settings

Cardiometabolic Guidelines: Cardiovascular Risk Assessment and Management in Patients with Dysglycemia

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