Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2015; 6(3): 391-402
Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.391
Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.391
Nociception at the diabetic foot, an uncharted territory
Ernst A Chantelau, Diabetic Foot Clinic, Heinrich-Heine-University Düsseldorf, 40001 Düsseldorf, Germany
Author contributions: Chantelau EA solely contributed to this article.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ernst A Chantelau, Professor, Diabetic Foot Clinic, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40001 Düsseldorf, Germany. chantelau@gmx.de
Telephone: +49-421-637196
Received: July 23, 2014
Peer-review started: July 25, 2014
First decision: September 16, 2014
Revised: September 18, 2014
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: April 15, 2015
Processing time: 270 Days and 11.5 Hours
Peer-review started: July 25, 2014
First decision: September 16, 2014
Revised: September 18, 2014
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: April 15, 2015
Processing time: 270 Days and 11.5 Hours
Core Tip
Core tip: The diabetic foot is characterised by painless ulcers and/or arthropathy. Although painless diabetic neuropathy is known as the underlying condition, little is known quantitatively about the pain evoked by noxious stimuli (nociception) at the diabetic foot. Preliminary evidence shows that pinprick pain perception threshold at plantar digital skinfolds is supranormal, beyond the upper limits of measurement. It is suggested that measuring nociception at the foot in diabetes could specify the individual risk of painless ulcers and/or arthropathy and, thereby, provide the basis of an individualised graded injury prevention strategy.