Why is it important for me to have an annual diabetic foot check?
Diabetes affects the circulation and nerves, primarily in your feet, eyes, and kidneys. The diabetic foot check is important to ensure the circulation to your feet is good and that you are not experiencing any loss sensation to your feet.
Why should I have a diabetic foot check?
The diabetic foot check assesses your risk of getting a diabetic foot ulcer as a result of your diabetes. Diabetic foot ulcers can result from either poor circulation, poor sensation, or a combination of both. Diabetic foot ulcers are hard to heal, can become easily infected, and can seriously compromise the health of your lower limb. Once you have had a foot ulcer there is a higher chance that you may get another. We want to reduce your risk of getting a foot ulcer as a result of your diabetes, which is why you should have an annual foot check.
What will happen at my diabetic foot check?
We will take a history of your current state of health, and any medication that you've been prescribed, including any medication that you take to control your diabetes. It is useful to know if you have a family history of diabetes too. If you smoke, you are strongly encouraged to seek help to quit.
We then check your foot pulses with our fingers to see if we can feel a pulse.
The pulse can be felt in two places on the foot, behind the inside of the ankle and over the top of the foot.
We will then listen to the foot pulses using a handheld doppler.
A doppler allows us to assess the quality of the blood flow into your feet, and the health of your arteries. If you have an irregular heartbeat, that will also be apparent.
Following a check of your circulation, we then move on to check your sensation.
To do this we use a 10g monofilament. We are checking to see whether or not you have a response to pain, for example, if you stub your toe, had a small stone in your shoe, or a painful callus/corn, would you feel it?
Damage to the nerves that tell our brain we are in pain can mean that, any trauma to the skin potentially goes unnoticed and may result in ulceration.
FOOT DEFORMITY & SKIN CONDITION
When we have checked the blood supply and sensation to your feet, we will then move on to assess your feet for any significant deformity, such as a large bunion or hammer toe.
We also look for anywhere you have hard skin or corns. Areas like this indicate there is some excessive pressure on the skin in those areas, which if left untreated can cause a breakdown of the skin beneath.
Finally, we look at your footwear, which should ideally be enclosed and with some sort of fastening - laces or velcro. It is not recommended that you wear sandals or flip flops as this can expose your feet to potential damage.
Who will do my diabetic foot check?
This may depend on your current risk factor towards developing an ulceration. A diabetic foot check is often carried out by a podiatrist, but can be carried out by any trained healthcare professional.
How often should I have a diabetic foot check?
You should have a diabetic foot check at least once a year. If you are high risk you may be asked to attend your podiatry clinic more often.
What happens after my diabetic foot check?
After considering the results of the investigations carried out we will give you your risk factor for developing a diabetic foot ulcer.
The three categories are:
Low risk - you will likely be in this category if you have pulses we can feel, good blood flow when we listen with the doppler and a normal response to the 10g monofilament.
Moderate risk - if you are classed as moderate risk we may have identified some problem with your circulation and/or sensation. You may also have some kind of foot deformity or hard skin, be a smoker or have had diabetes for a long time, or diabetes that is not very well controlled. There are many other factors that might be considered.
High risk - to be placed in this category you will have significant loss of sensation and/or circulation, in combination with significant deformity and/or hard skin. You will also be in the high risk category if you have suffered from previous foot ulcerations.
Don’t let a small problem turn into a big one.
You don’t have to wait for your annual foot check so your podiatrist can check your feet.
Contact your podiatrist straight away if you notice any changes to your feet. Your podiatrist will keep your nails at a good length and treat any corns or callus to reduce your chance of foot-related complications.
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