Lecture Hall Diabetic Foot | Neuropathy

Neuropathy

Available Credits
CPME 1.5

Lawrence Lavery
Lawrence Lavery, DPM, MPH
Professor
Department of Surgery
Scott & White Memorial Hospital and Clinic
Texas A&M University
Health Science Center College of Medicine
System Requirements Method of Participation Disclosure Information

Sensory neuropathy (loss of protective sensation) is one of the strongest risk factors for both foot ulceration and amputation in a patient with diabetes. Nerve damage associated with diabetes involves axonal degeneration of myelinated and unmyelinated nerves and involves loss of both small and large nerve fibers.

The diagnosis of diabetic sensory neuropathy is made based on review of the signs and symptoms, the results of the physical examination and diagnostic studies. Dr. Lavery reminds us that the use of a single instrument (Semmes-Weinstein monofilaments, for example), is not sufficient to make a definitive diagnosis. Patients with nutritional deficiencies, anemia, radiculopathies, alcoholism and other conditions present with symptoms very similar to diabetic sensory neuropathy.

Dr. Lavery reviews the various screening tests that will help the practitioner make a correct diagnosis. Standard vibration perception, deep tendon reflexes, motor strength, sharp/dull discrimination and light touch should all be part of the initial examination. While these tests are valuable, their results are difficult to quantify.

The biothesiometer is a unique device which can provide semi-quantitative information about the level of vibration the patient can feel in their foot. The information gleaned from this device helps us better understand the benefits and effectiveness of our treatment.

Monochromatic Near-Infrared Therapy, commonly known as Anodyne, has shown great promise. 98% of patients who received Anodyne Therapy for thirty minutes, three times weekly, had improvement after six weeks. The percentage of patients who saw improvement increased to one hundred percent, after twelve weeks of treatment. Dr. Lavery also discusses surgical decompression. This technique has shown great promise. However, he feels that more research is needed before it is used on a widespread basis in this high risk population.

Be aware - The answer to the question, "Can you do anything for the numbness and burning in my foot?", is rapidly changing.

Goal and Objective
After participating in this activity, the viewer should be better able to:
1. Recall the definition

Estimated time to complete this activity is 84 minutes.

Physicians, diabetes educators, and other health care professionals who treat patients with diabetes.
Accreditation and Designation of Credit
The Ohio College of Podiatric Medicine (OCPM) is an approved sponsor of Continuing Podiatric Medical Education through the Council on Podiatric Medical Education (CPME).

The Ohio College of Podiatric Medicine credits this activity for 1.5 credit hour.n/a

Release Date: 01/01/2007 Expiration Date: 12/31/2010
Peer Review: on 01/01/2007
Activity Number: n/a

System Requirements
Neuropathy
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Method of Participation
Neuropathy
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Complete the 4 steps to earn CE/CME credit:
  • Complete and submit the required pre-test
  • View Lecture
  • Complete and submit post-test and program evaluation. Credit will be issued with a passing score of 70% or better.
  • Click Print Certificate.
Disclosure Information
Neuropathy
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It is the policy of PRESENT e-Learning Systems and it's accreditors to insure balance, independence, objectivity and scientific rigor in all its individually sponsored or jointly sponsored educational programs. All faculty participating in any PRESENT e-Learning Systems sponsored programs are expected to disclose to the program audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education program. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts.
Lawrence Lavery, DPM, MPH has nothing to disclose.