A Comparative Study on Diabetic Foot Sensation between Digital Diabetic Foot Sensation Evaluated Meter (DDFM) and Monofilament

Abstract

                    Peripheral neuropathy is a common complication in diabetic patients, causing injury ulcer that may
spread to the patient may lose a finger or foot. Therefore, the patient’s feet must be assessed annually
with monofilament. But monofilament assessment cannot distinguish that is better or worse than before.
Therefore this study aimed to invent an innovation “Digital Diabetic Foot Sensation Evaluated Meter
(DDFM)” which could assess that pathology and compare the condition with the previous assessment.
The innovation was developed based on the principle of muscle stimulation through the skin which transmitting
an adjusted current until getting the electricity potential to stimulate the skin around the sole of
the foot. The use of a potential less than 5 volts could not harm the patient. The study procedure was
to assess the feet of diabetic patients who attend the diabetic foot clinic annually using monofilament,
and classified the risk into 3 levels: low, moderate and high. The next step was to assess sensation with
DDFM to measure the lowest electrical potential level that the patient’s feet began to perceive in each
foot as a digital number down to the millivolt. The resulting data were collected and compared. As for
the results, there were altogether 178 diabetic patients recruited], 63 males (35.4%), 115 females
(64.5%). Using monofilament test, the patients classified as low risk group had the lowest mean voltage
of 1.12±0.60 volts for right foot, and 1.10±0.61 volts for the left, the moderate risk group had lowest
average voltage of 1.30±0.62 volts for the right foot and 1.32±0.65 volts for the left one, and the high
level of risk group had the lowest average voltage of 1.57±0.73 volts for the right foot and 1.75±0.67
volts for the left. It was observed that the mean minimum voltage for each foot were not much different.
However, higher risk diabetes patients had higher electrical voltage perception than that of the lower risk
ones. This study with a digital Diabetic Foot Sensation Evaluated Meter (DDFM) showed that this new
method could differentiate patients at different risk levels more precisely. This makes it better to assess
diabetic neuropathy pathological changes than the traditional monofilament examination.