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 |
Foot care education. 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.
Specialty: Dermatology, Endocrinology, Surgery, general, Surgery, orthopedic