Recommendations: Foot Care (1)

Recommendations for foot care in patients with diabetes are summarized in four slides Slide 1 of 4 For all patients with diabetes, perform an annual comprehensive foot examination to identify risk factors predictive of ulcers and amputations The foot examination should include inspection, assessment of foot pulses, and testing for loss of protective sensation (LOPS) (10-g monofilament plus testing any one of: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold) (B) Amputation and foot ulceration, consequences of diabetic neuropathy and/or peripheral artery disease (PAD), are common and major causes of morbidity and disability in people with diabetes; early recognition and management of risk factors can prevent or delay adverse outcomes Risk of ulcers or amputations is increased in people who have the following risk factors: Previous amputation Past foot ulcer history Peripheral neuropathy Foot deformity Peripheral vascular disease Visual impairment Diabetic nephropathy (especially patients on dialysis) Poor glycemic control Cigarette smoking105Reference American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S37-S39.