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Original Articles

Comparison of Quantitative Sensory-Threshold Measures for Their Association With Foot Ulceration in Diabetic Patients

  1. Jay M Sosenko, MD, MS,
  2. Marta Kato, MD,
  3. Ramon Soto, MD and
  4. Diane E Bild, MD, MPH
  1. Department of Medicine, University of Miami School of Medicine Miami, Florida; and the Division of Diabetes Translation, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control Atlanta, Georgia
  1. Address correspondence and reprint requests to Jay M. Sosenko, MD, Department of Medicine, R-103, University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33101.
Diabetes Care 1990 Oct; 13(10): 1057-1061. https://doi.org/10.2337/diacare.13.10.1057
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Abstract

We compared the accuracy of cutaneous pressure perception-threshold measurements with that of other sensory-threshold measurements for detecting diabetic foot ulcer patients. Three hundred fourteen non-insulindependent diabetic patients were studied, of whom 91 had either a current foot ulcer or a history of foot ulceration. Foot ulcer patients had much higher pressure perception thresholds at the hallux than those without foot ulcers (mean ± SE 4.63 ± 0.05 vs. 3.54 ± 0.04 U, P < 0.001). The magnitude of association was higher than that for vibration thresholds and markedlygreater than those for cool and warm thresholds. Pressure thresholds were highly accurate for identifying foot ulcer patients. At a threshold level of 4.21 U, the sensitivity was 0.84, with a specificity of 0.96. At similar sensitivities for vibration and thermal thresholds, specificities were lower. Foot ulceration and cutaneous pressure perception threshold are strongly associated. Pressure-threshold measurements are extremely accurate and perform atleast as well as other quantitative sensory tests in identifying foot ulcer patients. Assessment of the foot pressure threshold may have promise as a simple and inexpensive method for detecting diabetic patients at risk for footulcers.

  • Received January 12, 1990.
  • Revision received April 4, 1990.
  • Accepted April 4, 1990.
  • Copyright © 1990 by the American Diabetes Association

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October 1990, 13(10)
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Comparison of Quantitative Sensory-Threshold Measures for Their Association With Foot Ulceration in Diabetic Patients
Jay M Sosenko, Marta Kato, Ramon Soto, Diane E Bild
Diabetes Care Oct 1990, 13 (10) 1057-1061; DOI: 10.2337/diacare.13.10.1057

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Comparison of Quantitative Sensory-Threshold Measures for Their Association With Foot Ulceration in Diabetic Patients
Jay M Sosenko, Marta Kato, Ramon Soto, Diane E Bild
Diabetes Care Oct 1990, 13 (10) 1057-1061; DOI: 10.2337/diacare.13.10.1057
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