Honors Theses

Date of Award

2016

Document Type

Undergraduate Thesis

Department

Pharmacy Administration

First Advisor

Matthew W. Strum

Relational Format

Dissertation/Thesis

Abstract

Evidence for adherence to the American Diabetes Association's (ADA) screening and treatment guidelines for various health complications of diabetes in rural populations is limited. The ADA recommends annual foot and eye exams and supports the use of the Semmes-Weinstein monofilament (SWM) to detect signs of diabetic peripheral neuropathy (DPN). This study evaluated the prevalence and treatment trends of DPN among patients with diabetes in a rural population. Fifty-two individuals over the age of 18, with known Type 1 or Type 2 diabetes mellitus, were recruited to participate. Participants were asked to respond to a 29-item, multiple choice and freeform question survey about the monitoring and management of their diabetes. A monofilament exam was then performed on each participant using a 10g SWM to detect signs of DPN. Six locations on the foot were tested with the 10g SWM, and a pedal pulse was recorded. The results of the 10g SWM exam were compared to the survey responses for each corresponding participant. Survey responses indicated that 21.2% of participants had been diagnosed with DPN. Although not statistically significant due to limited sample size, 17.3% of participants were identified by the SWM exam to have DPN but were currently undiagnosed by their physician. Furthermore, 12.0% of participants had not had an eye exam in over a year, and 28.8% did not have regular foot exams. Participants whose physicians performed regular foot exams were 3.0 times as likely to have an eye exam within the last year compared to participants whose physicians did not perform regular foot exams, demonstrating a positive correlation between foot and eye exams. The health consequences of undiagnosed sequelae of diabetes can be devastating. More specific data related to diabetes management and prevention of disease complications (via appropriate screening processes) in underserved areas is warranted; however, this study suggests that rural populations need greater attention and targeted educational programs to enhance the level of care.

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