Loss of protective foot sensation can markedly increase ulceration and amputation risk in diabetic peripheral neuropathy (DPN). A retrospective cross-sectional study published in Frontiers in Clinical Diabetes and Healthcare found that smoking, severe chronic kidney disease (CKD), prior ulceration, and amputation history were strongly associated with loss of protective sensation in adults with Type 2 diabetes.

The study included 387 patients with Type 2 diabetes diagnosed with DPN at University Hospital Sharjah between 2019 and 2024. Data were obtained from medical records. Patients were categorized by sensory status into loss of protective sensation (LOPS) or reduced protective sensation (RPS). Investigators compared groups using t-tests, chi-square testing, and multivariable logistic regression.

Overall, 45% of patients had LOPS, while 55% had RPS. Significant between-group differences were observed for smoking status, active ulcers, prior amputation, CKD severity, lipid profile, and glycated hemoglobin (HbA1c) levels. Patients with LOPS also had higher rates of foot complications and osteomyelitis.

In multivariable analysis, smoking was strongly associated with LOPS (odds ratio [OR]=38.91). Additional independent associations included ulcer history (OR=3.35), prior amputation (OR=3.46), and severe CKD (OR=6.04), with all p values below 0.01.

These findings are consistent with prior reports on DPN and also highlight additional associations related to loss of protective sensation. Patients with LOPS had higher rates of smoking, renal dysfunction, dyslipidemia, foot complications, and osteomyelitis. Early detection of these high-risk features and targeted interventions may help limit DPN progression and related foot complications.