The Ipswich Touch Test: a simple and novel method to screen patients with diabetes at home for increased risk of foot ulceration

Sharma, Sanjeev; Kerry, C.; Atkins, H.; Rayman, Gerry

doi:10.1111/dme.12450

Cited by 71 publications

(57 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If a 10‐g monofilament is unavailable, use the Ipswich Touch Test . While outcomes of this test were not included in the aforementioned meta‐analysis, the Ipswich Touch Test has shown results similar to testing with the 10‐g monofilament . Because limited vibratory sensation may also predict risk of foot ulceration, we suggest to screen for this with a tuning fork or biothesiometer/neurothesiometer, if outcomes from monofilament testing do not show LOPS.…”

Section: Recommendationsmentioning

confidence: 99%

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Bus

Lavery

Monteiro‐Soares

et al. 2020

Diabetes Metabolism Res

375

609

View full text Add to dashboard Cite

The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the prevention of foot ulceration in persons with diabetes and updates the 2015 IWGDF prevention guideline. We followed the GRADE methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical‐scientific literature, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where evidence was not available, and a weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to the intervention. We recommend to screen a person at very low risk for ulceration annually for loss of protective sensation and peripheral artery disease and persons at higher risk at higher frequencies for additional risk factors. For preventing a foot ulcer, educate the at‐risk patient about appropriate foot self‐care and treat any pre‐ulcerative sign on the foot. Instruct moderate‐to‐high risk patients to wear accommodative properly fitting therapeutic footwear, and consider instructing them to monitor foot skin temperature. Prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking to prevent plantar foot ulcer recurrence. In patients that fail non‐surgical treatment for an active or imminent ulcer, consider surgical intervention; we suggest not to use a nerve decompression procedure. Provide integrated foot care for high‐risk patients to prevent ulcer recurrence. Following these recommendations will help health care professionals to provide better care for persons with diabetes at risk of foot ulceration, to increase the number of ulcer‐free days, and to reduce the patient and health care burden of diabetic foot disease.

show abstract

Section: Recommendationsmentioning

confidence: 99%

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Bus

Lavery

Monteiro‐Soares

et al. 2020

Diabetes Metabolism Res

375

609

View full text Add to dashboard Cite

show abstract

“…Annual clinical foot examination for the component causes of amputation should be undertaken in patients with diabetes; this can be accomplished by way of very simple examinations for loss of protective sensation (testing pressure sensation with a monofilament, testing vibration sensation, or frankly the even simpler "touch the toes" approach adopted by Diabetes UK), [6][7][8] for arterial patency (pedal pulses and skin changes), and foot inspection for presence of abnormalities such as calluses or deformity that indicate repetitive minor trauma. Depending on their number and severity, the presence of abnormalities should trigger several interventions, beginning with self-foot care education and professionally fitted therapeutic footwear, to referral for wound management and surgical consultation.…”

Section: Key Pointsmentioning

confidence: 99%

Sounding the alarm on rising diabetes-related amputations

Perkins

2019

CMAJ

View full text Add to dashboard Cite

show abstract

“…Previous studies [12,18] were extremely relevant as support for this work. Their methodology was rigorous, and they were carried out in different environments with different professionals, presenting significant results with regards to their sensitivity and specificity in the use of the monofilament, in addition to their reliability, as indicated by the Kappa levels, in both tests.…”

Section: Discussionmentioning

confidence: 80%

Is it possible to substitute the monofilament test for the Ipswich Touch Test in screening for peripheral diabetic neuropathy?

Dutra¹,

Moura²,

Prado³

et al. 2020

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background: This study aimed to assess the agreement and efficacy of the Ipswich Touch Test compared to the monofilament test in individuals with type 2 diabetes. Materials and methods: A cross-sectional and analytical study was conducted. The inclusion criteria were patients with type II diabetes (n = 250) who did not present ulcers or amputation in either foot. The exclusion criteria were as follows: patients who presented sequelae of cerebrovascular disease or other neurological pathologies, as well as diagnoses of malignancy, alcohol abuse, liver cirrhosis, hepatitis B, AIDS, hypothyroidism, chronic kidney disease or lupus erythaematosus, as these clinical conditions could influence or bias the results (Won and Park in Endocrinol Metab 31:230-238, 2016). Sensitivity, specificity, predictive values, likelihood ratios, and Kappa index were calculated. Other factors assessed were glycated haemoglobin and body mass index. Results: Most of the participants were female (71.2%), and glycated haemoglobin (HbA1c) was greater than 7% in 54.4% of the patients. The mean age was 59.43 years, and the mean time since diagnosis was 12.38 years. The Kappa index was 0.819 (p < 0.001), and the Ipswich Touch Test had a sensitivity of 83.33%, a specificity of 97.66%, a positive predictive value of 85.71%, a negative predictive value of 97.21%, a positive likelihood ratio of 30.19%, and a negative likelihood ratio of 0.17%. The level of significance was 5% in this study. Conclusion: The Ipswich Touch Test resented good agreement and efficacy compared to the gold standard-the 10 g monofilament test.

show abstract

The Ipswich Touch Test: a simple and novel method to screen patients with diabetes at home for increased risk of foot ulceration

Cited by 71 publications

References 8 publications

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Sounding the alarm on rising diabetes-related amputations

Is it possible to substitute the monofilament test for the Ipswich Touch Test in screening for peripheral diabetic neuropathy?

Contact Info

Product

Resources

About