{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:39:20Z","timestamp":1781188760823,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the prevalence and potential risk factors for diabetic peripheral neuropathy with a loss of protective sensation in Barbados.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A representative population sample aged &gt; 25 years with previously diagnosed diabetes or a fasting blood glucose \u2265 7 mmol\/l or HbA<jats:sub>1c<\/jats:sub> \u2265 48 mmol\/mol (6.5%) was tested by 10 g monofilament at four plantar sites per foot and a 28 Hz tuning fork and neurothesiometer at the hallux. Data were adjusted to the age structure of people with diabetes in Barbados. Multivariable logistic regression assessed associations with peripheral neuropathy with a loss of protective sensation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 236 participants [74% response rate, 33% men, 91% black, median age 58.6 years, mean <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> 30.1 kg\/m<jats:sup>2<\/jats:sup>, mean HbA<jats:sub>1c<\/jats:sub> 54 mmol\/mol (7.1%)], 51% had previously diagnosed diabetes. Foot examination demonstrated that 25.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 20.2 to 31.5) had at least one insensate site with monofilament testing, 14.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 10.2 to 19.4) had an abnormal tuning fork test and 10.9% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 6.9 to 14.9) had a vibration perception threshold &gt; 25 V. Peripheral neuropathy with a loss of protective sensation prevalence was 28.5% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 22.7 to 34.4) as indicated by monofilament with \u2265 1 insensate site and\/or vibration perception threshold &gt; 25 V. With previously diagnosed diabetes the prevalence was 36.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 27.7 to 45.2) with 98.4% of cases identified by monofilament testing. Increasing age, previously diagnosed diabetes, male sex and abdominal obesity were independently associated with peripheral neuropathy with a loss of protective sensation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Over a third of people with previously diagnosed diabetes had evidence of peripheral neuropathy with a loss of protective sensation. Monofilament testing alone may be adequate to rule out peripheral neuropathy with a loss of protective sensation. Monofilament and neurothesiometer stimuli are reproducible but dependent on participant response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13989","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T06:00:04Z","timestamp":1557986404000},"page":"1629-1636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The prevalence of peripheral neuropathy severe enough to cause a loss of protective sensation in a population\u2010based sample of people with known and newly detected diabetes in Barbados: a cross\u2010sectional study"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-6769","authenticated-orcid":false,"given":"O. P.","family":"Adams","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences University of the West Indies Cave Hill Campus Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1827-8612","authenticated-orcid":false,"given":"J. R.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences University of the West Indies Cave Hill Campus Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Howitt","sequence":"additional","affiliation":[{"name":"George Alleyne Chronic Disease Research Centre University of the West Indies Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1368-1648","authenticated-orcid":false,"given":"N.","family":"Unwin","sequence":"additional","affiliation":[{"name":"George Alleyne Chronic Disease Research Centre University of the West Indies Barbados"},{"name":"MRC Epidemiology Unit University of Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008869"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.11.2636"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.14-4-367"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-9021"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.428"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.3.382"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMicm0810905"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400697"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.2.250"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2005.02.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250100013"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199801)15:1<80::AID-DIA517>3.0.CO;2-K"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2695"},{"key":"e_1_2_10_16_1","unstructured":"CHRC\/PAHO.Managing Diabetes in Primary Care in the Caribbean 2006."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2013.01.009"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S011"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-4-199"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1988.tb01003.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.9.2604"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2010.04.001"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(98)00100-4"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(1998120)15:12<1045::AID-DIA696>3.0.CO;2-L"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.00881.x"},{"key":"e_1_2_10_26_1","unstructured":"Barbados National Drug Formulary(April 1 2014 \u2010 March 31 2015) 33rd edn.The Barbados Government Printing Department Bay St. St. Michael: Barbados Drug Service Ministry of Health; 2014."},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.7.984"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.07.020407"},{"key":"e_1_2_10_29_1","unstructured":"Certified Methods and Laboratories. Available athttp:\/\/www.ngsp.org\/certified.asp. Last accessed 24 February 2019."},{"key":"e_1_2_10_30_1","unstructured":"HbA1c assay interferences. Available athttp:\/\/www.ngsp.org\/interf.asp. Last accessed 24 February 2019."},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002384"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.7.1162"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1102"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1107"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2012.03644.x"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13989","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13989","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.13989","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T15:13:31Z","timestamp":1694186011000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,18]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/dme.13989"],"URL":"https:\/\/doi.org\/10.1111\/dme.13989","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,18]]},"assertion":[{"value":"2019-05-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}