Diabetic Foot care Recommendations: Difference between revisions

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{{ADA guidelines}}
{{CMG}} {{AE}} {{SCh}}; {{TarekNafee}}
==2016 ADA Standards of Medical Care in Diabetes Guidelines==
{|class="wikitable"
{|class="wikitable"
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Perform a comprehensive foot eval- uation each year to identify risk fac- tors for ulcers and amputations. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Perform a comprehensive foot eval- uation each year to identify risk fac- tors for ulcers and amputations. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
Line 4: Line 8:
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Obtain a prior history of ulceration, amputation, Charcot foot, angio- plasty or vascular surgery, cigarette smoking, retinopathy, and renal dis- ease 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>
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Obtain a prior history of ulceration, amputation, Charcot foot, angio- plasty or vascular surgery, cigarette smoking, retinopathy, and renal dis- ease 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>
|-
|-
| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' The examination should include in- spection of the skin, assessment of foot deformities, neurological assess- ment 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>
| 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>
|-
|-
| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' Patients with a history of ulcers or amputations, foot deformities, in- sensate feet, and peripheral arte- rial disease are at substantially increased risk for ulcers and ampu- tations and should have their feet examined at every visit. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' Patients with a history of ulcers or amputations, foot deformities, in- sensate 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>
|-
|-
| bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' Patients with symptoms of claudi- cation 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>
| 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>
|-
|-
| 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 arte- rial 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>'''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 educa- tion to all patients with diabetes.''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
| 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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Revision as of 16:08, 12 December 2016

2016 ADA Guideline Recommendations

Types of Diabetes Mellitus

Main Diabetes Page

Diabetes type I

Diabetes type II

Gestational Diabetes Mellitus

2016 ADA Standard of Medical Care Guideline Recommendations

Strategies for Improving Care

Classification and Diagnosis of Diabetes

Foundations of Care and Comprehensive Medical Evaluation

Diabetes Self-Management, Education, and Support
Nutritional Therapy

Prevention or Delay of Type II Diabetes

Glycemic Targets

Obesity Management for Treatment of Type II Diabetes

Approaches to Glycemic Treatment

Cardiovascular Disease and Risk Management

Hypertension and Blood Pressure Control
Lipid Management
Antiplatelet Agents
Coronary Heart Disease

Microvascular Complications and Foot Care

Diabetic Kidney Disease
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Footcare

Older Adults with Diabetes

Children and Adolescents with Diabetes

Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes
Microvascular Complications in Children and Adolescents with Diabetes

Management of Diabetes in Pregnancy

Diabetes Care in the Hospital Setting

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. Perform a comprehensive foot eval- uation each year to identify risk fac- tors for ulcers and amputations. (Level of Evidence: B)"
"2. Obtain a prior history of ulceration, amputation, Charcot foot, angio- plasty or vascular surgery, cigarette smoking, retinopathy, and renal dis- ease 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, in- sensate 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)"
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