Diabetic foot screening: Difference between revisions
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==Screening== | ==Screening== | ||
*The main focus of [[diabetic foot]] [[screening]] should be on [[peripheral neuropathy]] detection, since [[foot]] [[ulcer]] development is rare in the absence of [[neuropathy]]. However searching for other factors such as [[skin]] integrity, any [[wound]] or [[ulceration]], [[anatomy|anatomical deformities]] and [[Anatomical terms of location|distal]] [[pulse|pulses]] should not be missed during [[foot]] [[Physical examination|examination]].<ref name="pmid9472210">{{cite journal| author=Armstrong DG, Lavery LA, Vela SA, Quebedeaux TL, Fleischli JG| title=Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. | journal=Arch Intern Med | year= 1998 | volume= 158 | issue= 3 | pages= 289-92 | pmid=9472210 | doi=10.1001/archinte.158.3.289 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9472210 }} </ref> | *The main focus of [[diabetic foot]] [[screening]] should be on [[peripheral neuropathy]] detection, since [[foot]] [[ulcer]] development is rare in the absence of [[neuropathy]]. However searching for other factors such as [[skin]] integrity, any [[wound]] or [[ulceration]], [[anatomy|anatomical deformities]] and [[Anatomical terms of location|distal]] [[pulse|pulses]] should not be missed during [[foot]] [[Physical examination|examination]].<ref name="pmid9472210">{{cite journal| author=Armstrong DG, Lavery LA, Vela SA, Quebedeaux TL, Fleischli JG| title=Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. | journal=Arch Intern Med | year= 1998 | volume= 158 | issue= 3 | pages= 289-92 | pmid=9472210 | doi=10.1001/archinte.158.3.289 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9472210 }} </ref><ref name="pmid15680122">{{cite journal| author=Pinzur MS, Slovenkai MP, Trepman E, Shields NN, Diabetes Committee of American Orthopaedic Foot and Ankle Society| title=Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society. | journal=Foot Ankle Int | year= 2005 | volume= 26 | issue= 1 | pages= 113-9 | pmid=15680122 | doi=10.1177/107110070502600112 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15680122 }} </ref> | ||
*A regular [[foot]] [[Physical examination|examination]] should be done in [[diabetes|diabetic]] [[patients]], in order to detecting [[peripheral neuropathy]], [[peripheral arterial disease]] and [[anatomy|anatomical]] [[foot]] deformities.<ref name="pmid23540807">{{cite journal| author=Brownrigg JR, Apelqvist J, Bakker K, Schaper NC, Hinchliffe RJ| title=Evidence-based management of PAD & the diabetic foot. | journal=Eur J Vasc Endovasc Surg | year= 2013 | volume= 45 | issue= 6 | pages= 673-81 | pmid=23540807 | doi=10.1016/j.ejvs.2013.02.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23540807 }} </ref> | *A regular [[foot]] [[Physical examination|examination]] should be done in [[diabetes|diabetic]] [[patients]], in order to detecting [[peripheral neuropathy]], [[peripheral arterial disease]] and [[anatomy|anatomical]] [[foot]] deformities.<ref name="pmid23540807">{{cite journal| author=Brownrigg JR, Apelqvist J, Bakker K, Schaper NC, Hinchliffe RJ| title=Evidence-based management of PAD & the diabetic foot. | journal=Eur J Vasc Endovasc Surg | year= 2013 | volume= 45 | issue= 6 | pages= 673-81 | pmid=23540807 | doi=10.1016/j.ejvs.2013.02.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23540807 }} </ref> | ||
*It is recommended to perform a careful [[foot]] [[physical examination|examination]] at least annually in [[diabetes|diabetic]] [[patients]] who are over the age of 15. Nevertheless physicians should educate [[patients]] to perform self [[foot]] [[physical examination|examination]] more often. | *It is recommended to perform a careful [[foot]] [[physical examination|examination]] at least annually in [[diabetes|diabetic]] [[patients]] who are over the age of 15. Nevertheless physicians should educate [[patients]] to perform self [[foot]] [[physical examination|examination]] more often. | ||
Revision as of 20:51, 5 March 2021
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Diabetic foot Microchapters |
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Diabetic foot screening On the Web |
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American Roentgen Ray Society Images of Diabetic foot screening |
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Risk calculators and risk factors for Diabetic foot screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Screening
- The main focus of diabetic foot screening should be on peripheral neuropathy detection, since foot ulcer development is rare in the absence of neuropathy. However searching for other factors such as skin integrity, any wound or ulceration, anatomical deformities and distal pulses should not be missed during foot examination.[1][2]
- A regular foot examination should be done in diabetic patients, in order to detecting peripheral neuropathy, peripheral arterial disease and anatomical foot deformities.[3]
- It is recommended to perform a careful foot examination at least annually in diabetic patients who are over the age of 15. Nevertheless physicians should educate patients to perform self foot examination more often.
- In diabetic patients who have higher risk of diabetic foot ulceration more frequent (every 1-6 months) examinations and follow up should be considered.
- The following are some useful screening tools for diabetic foot screening:[4][5][6][7]
- Semmes-Weinstein monofilament
- Tuning fork
- Biothesiometer
References
- ↑ Armstrong DG, Lavery LA, Vela SA, Quebedeaux TL, Fleischli JG (1998). "Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration". Arch Intern Med. 158 (3): 289–92. doi:10.1001/archinte.158.3.289. PMID 9472210.
- ↑ Pinzur MS, Slovenkai MP, Trepman E, Shields NN, Diabetes Committee of American Orthopaedic Foot and Ankle Society (2005). "Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society". Foot Ankle Int. 26 (1): 113–9. doi:10.1177/107110070502600112. PMID 15680122.
- ↑ Brownrigg JR, Apelqvist J, Bakker K, Schaper NC, Hinchliffe RJ (2013). "Evidence-based management of PAD & the diabetic foot". Eur J Vasc Endovasc Surg. 45 (6): 673–81. doi:10.1016/j.ejvs.2013.02.014. PMID 23540807.
- ↑ Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG (1998). "Practical criteria for screening patients at high risk for diabetic foot ulceration". Arch Intern Med. 158 (2): 157–62. doi:10.1001/archinte.158.2.157. PMID 9448554.
- ↑ Kumar S, Fernando DJ, Veves A, Knowles EA, Young MJ, Boulton AJ (1991). "Semmes-Weinstein monofilaments: a simple, effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration". Diabetes Res Clin Pract. 13 (1–2): 63–7. doi:10.1016/0168-8227(91)90034-b. PMID 1773715.
- ↑ Mueller MJ (1996). "Identifying patients with diabetes mellitus who are at risk for lower-extremity complications: use of Semmes-Weinstein monofilaments". Phys Ther. 76 (1): 68–71. doi:10.1093/ptj/76.1.68. PMID 8545495.
- ↑ Forouzandeh F, Aziz Ahari A, Abolhasani F, Larijani B (2005). "Comparison of different screening tests for detecting diabetic foot neuropathy". Acta Neurol Scand. 112 (6): 409–13. doi:10.1111/j.1600-0404.2005.00494.x. PMID 16281925.