Diabetic Foot care Recommendations: Difference between revisions
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==2016 ADA Standards of Medical Care in Diabetes Guidelines<ref name="urlcare.diabetesjournals.org">{{cite web |url=http://care.diabetesjournals.org/content/suppl/2015/12/21/39.Supplement_1.DC2/2016-Standards-of-Care.pdf |title=care.diabetesjournals.org |format= |work= |accessdate=}}</ref>== | |||
{|class="wikitable" | {|class="wikitable" | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Perform a comprehensive foot | | bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Perform a comprehensive foot evaluation each year to identify risk factors for ulcers and amputations. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Obtain a prior history of ulceration, amputation, Charcot foot, | | bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Obtain a prior history of ulceration, amputation, Charcot foot, angioplasty or vascular surgery, cigarette smoking, retinopathy, and renal disease and assess current symptoms of neuropathy (pain, burning, numbness) and vascular disease (leg fatigue, claudication). ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' The examination should include | | bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' The examination should include inspection of the skin, assessment of foot deformities, neurological assessment including 10-g monofilament testing and pinprick or vibration test- ing or assessment of ankle reflexes, and vascular assessment including pulses in the legs and feet. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' Patients with a history of ulcers or amputations, foot deformities, | | bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' Patients with a history of ulcers or amputations, foot deformities, insensate feet, and peripheral arterial disease are at substantially increased risk for ulcers and amputations and should have their feet examined at every visit. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' Patients with symptoms of | | bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' Patients with symptoms of claudication or decreased or absent pedal pulses should be referred for ankle-brachial index and for further vascular assessment. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''6.''' A multidisciplinary approach is recommended for individuals with foot ulcers and high-risk feet (e.g., dialysis patients and those with Charcot foot, prior ulcers, or amputation). ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | | bgcolor="Seashell"|<nowiki>"</nowiki>'''6.''' A multidisciplinary approach is recommended for individuals with foot ulcers and high-risk feet (e.g., dialysis patients and those with Charcot foot, prior ulcers, or amputation). ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''7.''' Refer patients who smoke or who have histories of prior lower- extremity complications, loss of protective sensation, structural abnormalities, or peripheral | | bgcolor="Seashell"|<nowiki>"</nowiki>'''7.''' Refer patients who smoke or who have histories of prior lower- extremity complications, loss of protective sensation, structural abnormalities, or peripheral arterial disease to foot care specialists for ongoing preventive care and lifelong surveillance. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''8.''' Provide general foot self-care | | bgcolor="Seashell"|<nowiki>"</nowiki>'''8.''' Provide general foot self-care education to all patients with diabetes.''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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Latest revision as of 20:47, 12 December 2016
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2016 ADA Guideline Recommendations |
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Types of Diabetes Mellitus |
|---|
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2016 ADA Standard of Medical Care Guideline Recommendations |
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Cardiovascular Disease and Risk Management |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Tarek Nafee, M.D. [3]
2016 ADA Standards of Medical Care in Diabetes Guidelines[1]
| "1. Perform a comprehensive foot evaluation each year to identify risk factors for ulcers and amputations. (Level of Evidence: B)" |
| "2. Obtain a prior history of ulceration, amputation, Charcot foot, angioplasty or vascular surgery, cigarette smoking, retinopathy, and renal disease and assess current symptoms of neuropathy (pain, burning, numbness) and vascular disease (leg fatigue, claudication). (Level of Evidence: B)" |
| "3. The examination should include inspection of the skin, assessment of foot deformities, neurological assessment including 10-g monofilament testing and pinprick or vibration test- ing or assessment of ankle reflexes, and vascular assessment including pulses in the legs and feet. (Level of Evidence: B)" |
| "4. Patients with a history of ulcers or amputations, foot deformities, insensate feet, and peripheral arterial disease are at substantially increased risk for ulcers and amputations and should have their feet examined at every visit. (Level of Evidence: C)" |
| "5. Patients with symptoms of claudication or decreased or absent pedal pulses should be referred for ankle-brachial index and for further vascular assessment. (Level of Evidence: C)" |
| "6. A multidisciplinary approach is recommended for individuals with foot ulcers and high-risk feet (e.g., dialysis patients and those with Charcot foot, prior ulcers, or amputation). (Level of Evidence: B)" |
| "7. Refer patients who smoke or who have histories of prior lower- extremity complications, loss of protective sensation, structural abnormalities, or peripheral arterial disease to foot care specialists for ongoing preventive care and lifelong surveillance. (Level of Evidence: C)" |
| "8. Provide general foot self-care education to all patients with diabetes.(Level of Evidence: B)" |
- ↑ "care.diabetesjournals.org" (PDF).