38 Comments
How often does your T1D health care provider screen for neuropathy with a monofilament, tuning fork or pin prick on your bare feet?
You must be logged in to post a comment.
© 2023 T1D Exchange. All Rights Reserved.
My Endo does an annual foot exam on all T1D & T2D patients. It is a separate appointment with attention only on my feet
I’ve seen my endo only once in person, but my primary care doctor checks for neuropathy in my feet about once per year.
I said, “At many of my appointments, but not all,” because I have done many video appointments. It seems that when I see my Endo, she routinely checks my feet. I’m not sure if it’s every time. She uses a pin prick on my foot and toes.
My endo knows I regularly see a podiatrist and leaves my feet alone. I do suffer with sever neuropathy below the knees.
I have already been diagnosed with peripheral neuropathy in my feet, so that test kind of doesn’t matter anymore. I think the last time that was done was when I saw the doctor rather than her nurse practitioners. So, maybe 9 months ago.
Having established that you have peripheral neuropathy, what has been done for it?
The doctor I had for 40 years tested every appt. My new, young has never tested me in two years. Kind of concerning.
Every in-person appointment he does (so pre pandemic was every appointment, but now it’s been once a year in person and the rest virtual)
My endo does sometimes and my podiatrist does at every appointment–usually once a year
Does the discovery of peripheral neuropathy lead to any kind of treatment?
Yes. Some have to take Lyrica or gabapentin for the pain.
Peripheral neuropathy is progressive and the meds do nothing but mask the pain … they do not reverse or stop the progression of the the neuropathy.
Best thing I found to deal with the weird sensations and discomfort is to invest in really comfortable and supportive shoes to wear. My neuropathic feet are healthy and functional wearing Orthofeet and Spenco comfort shoes. Plus I have custom orthotics made every other year to accommodate structural changes in my feet.
BTW, I danced since early childhood and was a semi-professional dancer in my young to mid adult years (ballet, modern, jazz, tap, musical comedy, international folk dancing, flamenco) and worked on my feet as a nurse for 30 years.
Not often at all. I have major calluses on my feet. I remember the first time I saw a new Endo, he commented on the “state of my feet”. He asked if I went barefoot a lot. I said, well as part of my job, yeah. He made a quip about stomping grapes? I said, no I am a member of the city ballet company. He then looked at my name, said “I know you”, I thought your name was familiar. He did the filament test on my arch, which threw me into a fit of ticklish giggles.
My endo rarely does it, but my neurologist and podiatrist check at every visit – usually once each per year,
I put other. I think maybe only twice in my 20+ years with T1D and only after I’ve asked about other foot issues.
I checked “never” which is accurate, BUT the reason is proper. Many years ago it became very clear that none of those tests were registering any reaction. I have not had any sensory perception for subtle touches in my feet for over twenty years.
My endo says neuropathy is for neurology and she doesn’t prescribe meds for it so she doesn’t check it. However, my primary care checks for that every time I’m in his office and prescribed gabapentin for it.
She won’t do that
First time, at last appointment. My son, age 11, will have had T1d for ten years this coming November.
I answered other because I am screened annually, which wasn’t an option.
Every appointment. Every three months.
I see the foot doctor every three months, and she performs this test every time.
This is done for me at every in-person appointment with either my podiatrist (annual) or my diabetic support team. However, most of my appointments with the diabetic support team (usually a remarkably capable PA) are virtual.
I get screened once a year.
When a new team of doctors and PAs came to the practice last year, the doctor/PA that was assigned to me started testing me every appointment. Before that, I couldn’t tell you the last time it was done.
My neuropathy manifests as lack of sensation, not pain, on a couple of toes on each foot. Any leg/foot pains disappeared when I got a plaster mold for each foot and was prescribed orthotics and deep-well shoes, which are covered by Medicare. Before my custom orthotics, I had so much leg pain I thought I would be confined to a wheelchair. Compression stockings also helped me.
During in-person appointments.
My previous endo did it every visit? But my current endo has never done it.
My neurologist did a ecg and found I’m in the starts of neuropathy.
I have but once a year she checks for worsening of systoms with it before I buy my yearly shoes it’s been stable for years so they quit doing it every 6 months
Only roughly on annual basis.
My endocrinologist knows that I see a podiatrist once a year. The podiatrist always uses monofilament and tuning fork.
Hah! Rarely anymore because I have known advanced peripheral neuropathy with significant loss of feeling in both feet for years. I see a highly skilled podiatrist to address the needs of my neuropathic feet, so it’s a moot point for my endocrine provider to do anything other than read the progress notes sent to her from the podiatrist.
I see a Podiatrist cut toenails every 3 months. He tests for loss of feeling but I can’t say how often. He sends report to my GP & Endocrinologist C-PA.
I really can’t answer that correctly because I have just started going back to my dr for in person visits since COVID. I have only been 2 xs since then and she hasn’t done that test, but prior to COVID she did it almost every visit.
Medical Practitioner: Times per Year
Foot Care Doc / Nurse 8 – 10 times
Podiatrist 1
Vascular Surgeon 2 – 3 times
Diabetes Nurse Practitioner < 10
General Health Doctor < 5
Once per year only with my Endo/Diabetes Doctor. But only to check progression, as I was diagnosed with peripheral neuropathy about 20 years ago. Interestingly, I have it worse in my fingers. hands and lower forearms. Which, I hear is not very common. My feet are standing up much better.
My PCP and Endo haven’t checked since the start of the COVID-19 pandemic.
I’m looking forward to seeing how this survey compares to the pre-pandemic surveys. I hear it takes a lot of work to get doctors to add a test to their patient interactions.