Diabetic Foot Assessment

This is conducted chiefly to help quickly identify patients at high risk of developing complications as a result of diabetes.

General social and medical history are considered first.

This is followed by a vascular assessment involving pulse palpation, visual check and activity proficiency; vital to evaluate possible signs of critical ischaemia.

Neurological assessment comprising touch sensation and motor output testing evaluate likelihood of future ulceration.

Feet and footwear are contemplated as foot shape and compatibility with shoes is essential in prevention of complications.

From these tests the patient can be placed in a risk category which indicates possible referral pathways.

Treatment

  • Prevention is better than cure in these cases. Early identification of skin changes is essential, requiring patient education to recognise and avoid high risk scenarios.
  • Existing ulcers can be protected and off-loaded with padding, orthoses, soft boots or if necessary bed rest.
  • Debridement of the wound may be necessary to create better conditions for healing.
  • Multidisciplinary team involvement may be necessary in order that your wound is re-dressed often enough.
  • Treatment of peripheral neuropathy & poor circulation
  • Treatment is based around prevention of signs and symptoms. This is achieved through blood glucose level control in the form of drug administration and nutritional advice.
  • The podiatrist conducts a full diabetic foot assessment  to gauge vascular, neurological and tissue status.
  • Complications of diabetes are treated as they occur and in conjunction with blood glucose control.

Footwear and orthotics play an important role in diabetic foot care to provide comfort and the following protective benefits:

  • High, wide toe box (high and wide space in the toe area)
  • Removable insoles for fitting flexibility and the option to insert orthotics if necessary.
  • Insoles or orthotics designed to reduce pressure in the areas of the foot most susceptible to pain, most notably the ball-of-the-foot.
  • Firm Heel Counters for support and stability.

If you are a diabetic, you should be particularly alert to any problems you may be having with your feet. It is very important for diabetics with neuropathy to take necessary precautions to prevent injury and keep their feet healthy. If you have diabetes and are experiencing a foot problem, immediately consult your Podiatrist.