It is not enough just to identify the patient at risk. Patients need close surveillance. And, of course, they need instruction on proper foot care and the selection of footwear. Without appropriate, timely, and definitive intervention, loss of protective sensation from whatever cause can lead to recurrent injury, progressive deformity, paralysis, and ultimately to amputation. The use of the nylon monofilament tester and Foot Screen should be part of the routine examination of all patients at risk of developing insensitive feet.
Effective prevention begins with competent assessment and patient education.
Foot problems are the major cause of amputation and physical disability in patients with diabetes. Yet studies have shown that simple techniques such as identifying patients at risk for foot ulcers, educating patients about foot care, and glucose control can prevent this serious complication. We know that simple education programs can enhance patients' preventive self-care behaviors. We have simple, effective tools to identify patients at high risk, and we have the ability to obtain protective footwear for many of our patients. Now, we need to use this information and these tools to start preventing these tragic LEA's, with their immense burden in terms of personal suffering and financial cost.