Sharma S, Kerry C, Atkins H, Rayman G, et al.
Diabetic medicine : a journal of the British Diabetic Association. Date of publication 2014 Sep 1;volume 31(9):1100-3.
1. Diabet Med. 2014 Sep;31(9):1100-3. doi: 10.1111/dme.12450. Epub 2014 Apr 11.
The Ipswich Touch Test: a simple and novel method to screen patients with
diabetes at home for increased risk of foot ulceration.
Sharma S(1), Kerry C, Atkins H, Rayman G.
Author information:
(1)Diabetes Research Unit, The Ipswich Hospital NHS Trust, Ipswich, UK.
Comment in
Ann Intern Med. 2015 Feb 17;162(4):JC10.
Praxis (Bern 1994). 2015 Jan 2;104(1):53.
AIMS: The Ipswich Touch Test is a novel method to detect subjects with diabetes
with loss of foot sensation and is simple, safe, quick, and easy to perform and
teach. This study determines whether it can be used by relatives and/or carers to
detect reduced foot sensation in the setting of the patient's home.
METHODS: The test involves lightly and briefly (1-2 s) touching the tips of the
first, third and fifth toes of both feet with the index finger. Reduced foot
sensation was defined as ≥ 2 insensate areas. Patients due to attend clinic over
a 4-week period were invited by post. The invitation contained detailed
instructions and a sheet for recording the results. The findings were compared
with those obtained in clinic using the 10-g monofilament at the same six sites.
RESULTS: Of 331 patients (174 males), 25.1% (n = 83) had ≥ 2 insensate areas to
10-g monofilament testing. Compared with this, the Ipswich Touch Test at home had
a sensitivity of 78.3% and a specificity of 93.9%. The predictive values of
detecting 'at-risk' feet were positive at 81.2% and negative at 92.8%. The
likelihood ratios were positive at 12.9 and negative at 0.23.
CONCLUSIONS: With clearly written instructions, this simple test can be used by
non-professionals to accurately assess for loss of protective sensation. We
believe that the Ipswich Touch Test may also be a useful educational adjunct to
improve awareness of diabetes foot disease in patients and relatives alike and
empower them to seek appropriate care if sensation was found to be abnormal.
© 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.
DOI: 10.1111/dme.12450
PMID: 24673517 [Indexed for MEDLINE]