Diabetic foot disease is a major complication of diabetes and is often an overlooked aspect of Diabetic management.
If you have been diagnosed with either Type I or Type II Diabetes then it is especially important that you have your feet checked and treated regularly by a Podiatrist. Raised blood glucose levels over a period of time can contribute to complications to all organs of the body including the feet.
Other complications for people with peripheral neuropathy are a loss of balance and coordination, and muscle weakness in the feet, which can lead to falls.
This is to check the circulation in the legs and feet, to visually observe any problems, assess any temperature differences and any changes to the skin and nails which would indicate vascular problems. We also use a Doppler Ultrasound, which involves placing an ultrasound gel over the pulse areas of the feet and ankle to listen to the strength and regularity of the arteries in the legs and feet. Included is the Ankle Brachial Pressure index found from the systolic pressure in the arm and ankle (explained in the Peripheral Arterial Disease assessment).
This assessment is intended to check the correct function of nerves in the feet using a 10g monofilament - a diagnostic tool for observing any loss of nerve sensation or ‘neuropathy’. Tuning fork- to establish vibration. Proprioception- manual movement of the toes to ascertain that the brain can still recognise where the toes are. Gait assessment- whether the way you walk has become unstable and a bit wobbly. After this stage, if we suspect there may be a nerve related issue we will then apply a Neuropad, which is a small pad designed to indicate if neuropathic changes are happening in the feet.
We will provide you with the relevant advice that you need to make sure that your feet are safe and comfortable between appointments. The footwear advice we provide is crucial as appropriately fitting shoes are a key factor in maintaining healthy Diabetic feet.
Approximately an hour as done alongside the vascular assessment, please wear lose clothing to the assessment.
The areas covered in the assessment are recommended in the NICE (National Institute of Clinical Excellence) guidelines.
The diabetic app from the Society of Podiatrists and Chiropodist website can be downloaded to a mobile phone for patients to use.