State Registered Podiatrists play an important role in the education, monitoring and treatment of patients presenting with lower limb complications of their diabetes.
- All people with diabetes should receive education in foot care, to reduce the incidence of chronic ulceration, gangrene and amputation.
- Foot examination should be performed at the annual review visit in all patients (view link)
- Use of a 10g Monofilament is also encouraged.
- Use the on-line FOOT SCREEN within SCI-DC clinical area to record examination findings
- Ongoing management depends upon risk stratification. which is automatically calculated using this tool.
Basic Footcare Advice
| DO |
DO NOT |
| Examine feet daily, including between toes and around heels (contact podiatrist/nurse in emergency) |
Wear ill-fitting shoes |
| Check footwear for small objects or rough seams |
Burst blisters |
| Wash feet daily and dry thoroughly |
Sit too near heaters or fires or use hot water bottles to heat feet up quickly |
| Check water temperature with elbow before bathing feet |
Poke down edges of nails with scissors to cure ingrown toenails |
| Switch off electric blankets and remove hot water bottles before going to bed. |
Use razor blades, pumice stones or corn remedies |
| Ask for feet to be measured when buying shoes |
Wear sandals if there is any loss of sensation in the feet |
| Follow this advice and have feet checked regularly |
Go barefoot. |
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Aims of Diabetic Footcare Advice
- Education of patients and/or carers on the importance of self-care
- Prevention of trauma and subsequent development of foot lesions
- To aid healing of established lesions and prevention of recurrence
- To maintain patient mobility and avoid hospital admission
- Adherence to national guidelines, to reduce the morbidity associated with diabetic foot disease
Objectives of Diabetic Footcare
- To provide all diabetic patients with education on footcare
- To ensure that all patients receive annual foot examination
- To provide a service whereby patients are referred appropriately to members of a specialist team, according to level of risk
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Foot Assessment
The SCI-DC Foot Screening Tool can be found by clicking on the “Foot Screening form” icon within the patient’s SCI-DC Patient Summary Data Screen. A screen shot of the tool is below.
Testing Pressure Sensation with a Monofilament
- Monofilaments are designed to deliver a standard stimulus independent of the pressure applied
- Test a total of 10 sites: 1st, 3rd & 5th plantar metatarsal heads, plantar aspect of great toe and apex of 3rd toe in both feet.
- If the patient is able to feel < 8/10 touches with a monofilament, then the risk of foot ulceration is increased 5-10 fold.
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