Wczesna diagnostyka neuropatii cukrzycowej i prewencja amputacji kończyn dolnych, u chorych na cukrzycę, w warunkach praktyki lekarza POZ, ze szczególnym uwzględnieniem monofilamentu nylonowego (Semmes-Weinstein) 5.07/10

Małgorzata Koziarska-Rościszewska

Summary
Diabetes mellitus is associated with increased morbidity, disability and mortality. Especially it´s chronic late-stage complications cause serious medical and economic problems.The majority of costs (in the human and economic meaning) is due to diabetic foot and diabetic ulcerations – common foot injuries often leading to lower extremity amputations. An alarming level of over 50% of all nontraumatic amputations occur in diabetics. The risk of the lower limb loss is 15-46 fold higher in diabetics than in nondiabetics. Scientific research proves that over 80% of the amputations should be potentially preventable if appropriate screening, prevention methods and proper management were instituted. Diabetic peripheral neuropathy is one of the most important ethiologic factors for foot ulcers. It is considered to be an essential permissive factor in the diabetic foot – diabetic ulcers – development. All the efforts should pursue one purpose: the identification of „high risk” patients and the prevention of the foot lesions. Scientific data show that 2/3 diabetics all over the world are treated in the primary care setting.Therefore family physician plays a pivotal role in early detection of the disturbances connected with diabetic foot. It is necessary to perform valid and reliable but simple test for identifying patients at risk for developing foot ulcers and subsequent amputation. Semmes-Weinstein monofilament seems to be a useful tool for Neuropathy screening in the outpatient care setting.

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