Presentation of information for a comprehensive diabetic foot examination that is used in conjunction with the exam. Healthcare guide to diabetes and your feet can be obtained at www.drpelto.com
2. What is it?
• An examination to evaluate and determine
risk factors for patient’s with diabetes
performed on regular basis based on
symptoms.
– Diabetes with no risk factors – Yearly
– Diabetes with 1 risk factor – 2x a year
– Diabetes with 2 risk factors – 3x a year
3. What are the risk factors?
• Diabetes with the following
– Foot deformity (Bunion, Hammertoe, Equinus)
– Skin problems (Ulceration, Athlete’s Foot,
Calluses, Fungal Nails)
– Poor feeling (Neuropathy)
– Poor circulation (Peripheral vascular disease)
– Improper shoe gear
4. Initial Information
• Last footcare visit • Doctor treating your
• Last CDFE diabetes (PCP or
• Changes medical Endocrinologist)
history • Last date seen
• Changes to
medications
• New foot concerns
5. Fasting Blood Sugar
• Fast overnight or
don’t eat anything for
8 hours
• Draw blood to
determine amount of
blood sugar
15. Skin Problem –
Advanced Wound Therapy
• Dermagraft
• If a wound does not
decrease by 50% in 4
weeks advanced
therapies
recommended.
• Reduces risk of
amputation and
infection.
19. Diabetic Shoes –
Preventing Amputations
Most patient’s with Diabetes
Qualify for a pair of Diabetic
Shoes each year.
• Partial/Complete
Amputation
• Previous
Ulceration
• Pre-Ulcerative
Callus
• Neuropathy with
Callus
• Poor Circulation
• Foot Deformity
20. Footwear at Home –
Preventing Injury
• Crocs – wide toe box,
seamless interior, silver
for antifungal and bacteria
and toe cap
21. Diabetic Socks
• Seamless
• Reduces friction that
can lead to ulceration
and wounds
• Compression socks if
have swelling
22. Conclusion
• Control blood sugar and Hemoglobin A1C
• Dangers of neuropathy and “gift of pain”
• Risk Stratification
– No Neuropathy – Yearly
– Neuropathy – 2 x Year
– Neuropathy, PVD and/or deformity – 4 x Year
– Previous Ulcer or Amputation – 6 x Year
23. Conclusion
• High pressure areas, risks and offloading
• Proper foot care (reverse of Pressure Stat)
• Daily self-examination and monitoring feet
• Review of current medications
• Next Exam