Attend the annual review appointments with a NHS podiatrist so that they can monitor signs of loss of protective sensation
and foot health in general.
The neurotraumatic theory emphasises the importance of a loss of protective sensation in allowing progressive destruction of bones and joints because of repetitive mechanical trauma to the foot.
The exact pathophysiology is unclear and speculative, although a loss of protective sensation, autonomic neuropathy and trauma are the most important determinants.
The loss of protective sensation
can be evaluated with the use of a nylon Semmes-Weinstein monofilament.
We concur with the recommendation made in the companion article by Mayfield and Sugarman that at this time the SWM should be the screening instrument of choice for loss of protective sensation because of its ability to predict foot ulceration, its ease of use, and its low cost and portability.
This should include assessment of loss of protective sensation and PVD.
Effective July 1, 2002, Medicare covers physician evaluation of patients with a documented diagnosis of diabetic sensory neuropathy and loss of protective sensation
He reasoned that both suffered a loss of protective sensation
that allowed trauma to occur and continue without uncomfortable warning signals.
Medicare will begin to cover semiannual podiatric foot exams for diabetes patients, as long as their referring physicians have established a diagnosis of peripheral neuropathy with loss of protective sensation
Diabetic foot ulcers generally result from the consequences of peripheral neuropathy, with loss of protective sensations
and foot deformities.