Brownlee et al used a simple algorithm to help guide foot care in a patient with diabetes mellitus.
Risk factors to screen for at each examination:
(1) peripheral neuropathy
(2) peripheral vascular disease
(3) foot deformity
(4) edema
(5) history of previous foot ulceration
(6) other diabetic complications
Others that I would add:
(7) foot trauma
(8) current foot ulcerations
Management
Immediate Instruction
Followup
no risk factors
Foot care education.
Advice on footwear.
Advice on podiatry.
at least annually
1 or more risk factors
Consider special footwear.
Regular podiatry.
several times a year, depending on the number and severity of risk factors; always inspect the feet at each visit
Inspection of the feet of a diabetic at each examination is simple and effective.
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Specialty: Dermatology, Endocrinology, Surgery, general, Surgery, orthopedic
