Diabetic neuropathy: pathophysiology and prevention of foot ulcers.

George Zangaro, M. M. Hull

Research output: Contribution to journalReview article


Diabetic neuropathy, which affects 60% to 70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes, often leading to foot ulcers and potentially to lower limb amputations, both of which are preventable. The physiologic, structural, and functional changes associated with diabetic neuropathy and foot ulcers are discussed. Advanced practice nurses are in a unique position to implement strategies for the prevention of serious and debilitating complications from diabetic neuropathy, including foot assessment, education, and specialist referrals. Research evidence is given to support the use of the Semmes-Weinstein monofilaments to evaluate decreased plantar sensation, a common precursor to ulceration. Ongoing patient and family education can emphasize the importance of preventive self-care measures. Referrals for specialist care and therapeutic footwear can be made by advanced practice nurses. If begun early, these interventions can prevent foot ulcers from diabetic neuropathy, thereby improving the quality of life and reducing healthcare costs for this chronic disease.

Original languageEnglish (US)
JournalClinical nurse specialist CNS
Issue number2
StatePublished - Mar 1999
Externally publishedYes


ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Assessment and Diagnosis
  • Leadership and Management
  • LPN and LVN

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