Diabetic Foot Screening
Screening of foot in diabetes is an essential part of the examination carried out . The aim of this examination is to determine as early as possible any risk factors for diabetic foot complications such as neuropathy and ischaemia amongst other things, and reduce amputations and ulcerations with timely referrals. Studies have shown that early detection and intervention may prevent up to 85% of amputations in diabetic patients.
It is important to inform the podologist if one is having any problems with their feet such as:
· Burning Sensation.
· Pins And Needles.
· Problems with Corns And Nails.
The following should be reported immediately to your caring doctor/podologist:
· Open Wounds And Any Ulcers.
· Areas of Bluish/Black Skin.
· In growing Toe Nail +/- With Discharge.
· Color Change - Red Hot Skin Which May Also Be Swollen.
· Increase in Skin Foot Temperature.
Patients will be risk categorized and if indicated referred for further assessment.
Patient care pathway for screening of patients for Diabetic foot complications
All patients attending the Diabetes clinics in all the health centers are obliged to have screening for the feet. The nurse leading the diabetes clinic will make sure that the screening actually takes place and the GP refers patient accordingly.
Initial Assessment (Level 1 screening)
All patients will undergo neurological and vascular assessment by the Podiatrists using the mono filament and Doppler ultrasound, The findings are recorded in the specified form DH 140. If initial assessment is certified to be normal then the patient is given a yearly appointment and referred back to the Diabetes
1. Comprehensive Diabetes Foot Screening
o All Primary Care Health Centres
o High risk are referred for further screening
2. Intensive Foot Screening
o Floriana Health Centre by trained podiatrists
o Ankle Brachial Pressure Index (ABPI), Neuropathy scores, Footwear, Biomechanical examination
o Critical/rest pain/ low ABPIs referred for vascular assessment
3. Vascular Assessment
o MDH by a trained podiatrist
o ABPI, TBI, Doppler waveforms, segmental studies, venous PPG
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