The Ipswich Touch Test is a quick and sensitive test for diabetic neuropathy. The test is done by lightly touching the ends of the first, third and fifth toes of both feet (with a total of six toes) with the clinicians index finger for 1-2 seconds. They are asked to identify when the toe is touched. A reduced foot sensation using this test is generally considered when there being ≥ 2 areas that have lost sensation.

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The Ipswich Touch Test (IpTT) is a simple, quick, and effective screening method used to assess peripheral neuropathy—a condition often seen in people with diabetes that leads to loss of sensation in the feet. Peripheral neuropathy increases the risk of developing foot ulcers, which can eventually lead to serious complications like infections or even amputations. The Ipswich Touch Test was designed as an easy alternative to more specialized tools, allowing healthcare providers—or even trained caregivers—to identify patients who might have lost protective sensation in their feet.

The procedure itself is extremely straightforward. During the test, the examiner lightly touches the tips of the patient’s first, third, and fifth toes on each foot using the index finger for about 1–2 seconds. The key is to use a light touch—enough for someone with normal sensation to feel, but gentle enough that those with neuropathy may not. The patient should have their eyes closed throughout the test to ensure they are responding to sensation rather than visual cues. If the patient fails to feel two or more touches out of the six possible points, it suggests a loss of protective sensation, indicating peripheral neuropathy.

One of the main advantages of the Ipswich Touch Test is its accessibility and simplicity. Unlike other diagnostic tools such as the 10g monofilament or vibration perception tests, the IpTT requires no equipment, making it ideal for use in low-resource settings or community screenings. It’s cost-free, quick (taking less than a minute per patient), and can be easily taught to non-specialist staff or even family members caring for someone with diabetes. Despite its simplicity, studies have shown that the Ipswich Touch Test has a high sensitivity and specificity, making it a reliable tool for early neuropathy detection.

In summary, the Ipswich Touch Test plays a crucial role in preventive diabetic foot care. By identifying individuals at risk of neuropathy early, it enables timely interventions—like patient education, proper footwear, and regular foot checks—that can prevent ulcers and amputations. Its simplicity makes it a valuable public health tool, promoting awareness and empowering both healthcare professionals and patients to take proactive steps in managing diabetic foot health.

Most Useful Resources:
The Ipswich Touch Test for diabetic neuropathy (Podiatry Arena)
Ipswich Touch Test (PodiaPaedia)

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