Diabetic Foot Care

Firstly, Risk Assessment:
- peripheral neuropathy
- peripheral vascular disease
- previous ulceration
- foot deformity
- poor glycaemic control
- absence of footcare education
- low SES

If low risk foot

- General foot care and advice
- Annual review (use monofilament)

If “At risk” foot i.e. neuropathy, absent pulses, or other risk factor

Conservative:
Education about the risk of foot problems,
Advise patient about daily inspection
Foot protection - avoidance of walking on bare foot, wearing of well fitting footware and loose cotton socks

If there is Ulcer -As above with :

Conservative:
Education about the risk of foot problems,
Advise patient about daily inspection
Foot protection - avoidance of walking on bare foot, wearing of well fitting footware and loose cotton socks

Medical: IV antibiotics

Surgical:
Wound debridement
Evaluate patient for PVD with ABI
Evaluate bone involvement if bone seen or easily detected by probing or if ulcer depth is more than 3mm and ESR more than 40
X ray
Bone scan
MRI ( 98 % sensitivity and 81 % specificity )