Journal of Diabetes and Its Complications
AT A GLANCE
PURPOSE: To determine whether treatment with MIRE was, in fact, associated with increased foot sensitivity to the Semmes Weinstein monofilament and a reduction in neuropathic pain in patients with established peripheral neuropathy.
PATIENT(S): The medical records of 2239 patients (mean age=73 years) with established peripheral neuropathy (PN) were examined. The PN in 1395 of these patients (62%) was due to diabetes.
RESULTS: Prior to treatment with MIRE, of the 10 tested sites (5 on each foot), 7.1F2.9 were insensitive to the SWM 5.07, and 2078 patients (93%) exhibited loss of protective sensation defined by Medicare as a loss of sensation at two or more sites on either foot.
After treatment, the number of insensate sites on both feet decreased to 2.4F2.6, an improvement of 66%.
Of the 2078 (93%) patients initially presenting with loss of protective sensation, 1106 (53%) no longer had loss of protective sensation after treatment (Pb.0001); 1563 patients (70%) also exhibited neuropathic pain in addition to sensory impairment.
Prior to treatment with MIRE, pain measured on the 11-point visual analogue scale (VAS) was 7.2F2.2 points, despite the use of a variety of pain-relieving therapeutic agents. After treatment with MIRE, pain was reduced by 4.8F2.4 points, a 67% reduction.
CONCLUSIONS: MIRE appears to be associated with significant clinical improvement in foot sensation and, simultaneously, a reduction in neuropathic pain in a large cohort of primarily Medicare aged, community-dwelling patients, initially diagnosed with PN. The quality of life associated with these two outcomes cannot be under appreciated.