{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:41:01Z","timestamp":1791387661044,"version":"4.3.3"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the feasibility of a one\u2010stop microvascular screening service for the early diagnosis of diabetic distal symmetrical polyneuropathy, painful distal symmetrical polyneuropathy and the at\u2010risk diabetic foot.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>People with diabetes attending retinal screening in hospital and community settings had their feet examined by a podiatrist. Assessment included: Toronto Clinical Neuropathy Score evaluation; a 10\u2010g monofilament test; and two validated, objective and quick measures of neuropathy obtained using the point\u2010of\u2010care devices \u2018<jats:styled-content style=\"fixed-case\">DPN<\/jats:styled-content>\u2010Check\u2019, a hand\u2010held device that measures sural nerve conduction velocity and amplitude, and \u2018Sudoscan\u2019, a device that measures sudomotor function. The diagnostic utility of these devices was assessed against the Toronto Clinical Neuropathy Score as the \u2018gold standard\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 236 consecutive people attending the retinal screening service, 18.9% of whom had never previously had their feet examined, were evaluated. The prevalence of distal symmetrical polyneuropathy, assessed using the Toronto Clinical Neuropathy Score, was 30.9%, and was underestimated by 10\u2010g monofilament test (14.4%). The prevalence of distal symmetrical polyneuropathy using <jats:styled-content style=\"fixed-case\">DPN<\/jats:styled-content>\u2010check was 51.5% (84.3% sensitivity, 68.3% specificity), 38.2% using Sudoscan foot electrochemical skin conductance (77.4% sensitivity, 68.3% specificity), and 61.9% using abnormality in either of the results (93.2% sensitivity, 52.8% specificity). The results of both devices correlated with Toronto Clinical Neuropathy Score (<jats:italic>P<\/jats:italic>&lt;0.001). A new diagnosis of painful distal symmetrical polyneuropathy was made in 59 participants (25%), and 56.6% had moderate\u2010 or high\u2010risk foot. Participants rated the service very highly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Combined, eye, foot and renal screening is feasible, has a high uptake, reduces clinic visits, and identifies painful distal symmetrical polyneuropathy and the at\u2010risk foot. Combined large\u2010 and small\u2010nerve\u2010fibre assessment using non\u2010invasive, quantitative and quick point\u2010of\u2010care devices may be an effective model for the early diagnosis of distal symmetrical polyneuropathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13630","type":"journal-article","created":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T16:58:48Z","timestamp":1522688328000},"page":"887-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["One\u2010stop microvascular screening service: an effective model for the early detection of diabetic peripheral neuropathy and the high\u2010risk foot"],"prefix":"10.1111","volume":"35","author":[{"given":"O.","family":"Binns\u2010Hall","sequence":"first","affiliation":[{"name":"Department of Podiatry Services Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Selvarajah","sequence":"additional","affiliation":[{"name":"Department of Diabetes Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Sanger","sequence":"additional","affiliation":[{"name":"Department of Podiatry Services Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Podiatry Services Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Oncology and Human Metabolism University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-1472","authenticated-orcid":false,"given":"S.","family":"Tesfaye","sequence":"additional","affiliation":[{"name":"Department of Oncology and Human Metabolism University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Diabetes UK.Twenty devastating amputations ever day. 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