Diabetic foot screening: Difference between revisions

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*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.  
*In [[diabetes|diabetic]] [[patients]] who have higher risk of [[diabetic foot]] [[ulcer|ulceration]] more frequent (every 1-6 months) [[physical examination|examinations]] and follow up should be considered.  
*In [[diabetes|diabetic]] [[patients]] who have higher risk of [[diabetic foot]] [[ulcer|ulceration]] more frequent (every 1-6 months) [[physical examination|examinations]] and follow up should be considered.  
*An evidence‐based guideline published by the International Working Group on the [[diabetic foot]] (IWGDF), has been demonstrated a risk stratification system for detecting [[diabetes|diabetic]] [[patients]] with high risk of [[foot]] [[ulcer|ulceration]]. The aforementioned guideline has been developed a scoring system which clarify the proper intervals for [[screening]] [[diabetes|diabetic]] [[patients]].  The following table is a summary of this system:<ref name="pmid32176451">{{cite journal| author=Bus SA, Lavery LA, Monteiro-Soares M, Rasmussen A, Raspovic A, Sacco ICN | display-authors=etal| title=Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). | journal=Diabetes Metab Res Rev | year= 2020 | volume= 36 Suppl 1 | issue=  | pages= e3269 | pmid=32176451 | doi=10.1002/dmrr.3269 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32176451  }} </ref>
*An evidence‐based guideline published by the International Working Group on the [[diabetic foot]] (IWGDF), has been demonstrated a risk stratification system for detecting [[diabetes|diabetic]] [[patients]] with high risk of [[foot]] [[ulcer|ulceration]]. The aforementioned guideline has been developed a scoring system which clarify the proper intervals for [[screening]] [[diabetes|diabetic]] [[patients]].  The following table is a summary of this system:<ref name="pmid32176451">{{cite journal| author=Bus SA, Lavery LA, Monteiro-Soares M, Rasmussen A, Raspovic A, Sacco ICN | display-authors=etal| title=Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). | journal=Diabetes Metab Res Rev | year= 2020 | volume= 36 Suppl 1 | issue=  | pages= e3269 | pmid=32176451 | doi=10.1002/dmrr.3269 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32176451 }} </ref><ref name="pmid32176447">{{cite journal| author=Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Hinchliffe RJ, Lipsky BA | display-authors=etal| title=Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). | journal=Diabetes Metab Res Rev | year= 2020 | volume= 36 Suppl 1 | issue=  | pages= e3266 | pmid=32176447 | doi=10.1002/dmrr.3266 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32176447 }} </ref>
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Revision as of 18:36, 7 March 2021

Diabetic foot Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diabetic foot from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

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Other Imaging Findings

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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


Characteristics Score Risk of ulcer development Recommended screening frequency
Intact protective sensation of foot
Absent of peripheral artery disease
0 Very low Annually
Impaired protective sensation of foot
OR
Peripheral artery disease
1 Low Every 6‐12 months
Impaired protective sensation of foot AND peripheral artery disease
OR
Impaired protective sensation of foot AND foot deformity
OR
Peripheral artery disease AND foot deformity
2 Moderate Every 3‐6 months
Impaired protective sensation of foot OR peripheral artery disease
AND at least one of the following:
Previous history of a foot ulcer
Previous history of amputation of a lower extremity
End‐stage renal disease
3 High Every 1‐3 months


References

  1. 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.
  2. 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.
  3. Mishra SC, Chhatbar KC, Kashikar A, Mehndiratta A (2017). "Diabetic foot". BMJ. 359: j5064. doi:10.1136/bmj.j5064. PMC 5688746. PMID 29146579.
  4. 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.
  5. Bus SA, Lavery LA, Monteiro-Soares M, Rasmussen A, Raspovic A, Sacco ICN; et al. (2020). "Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)". Diabetes Metab Res Rev. 36 Suppl 1: e3269. doi:10.1002/dmrr.3269. PMID 32176451 Check |pmid= value (help).
  6. Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Hinchliffe RJ, Lipsky BA; et al. (2020). "Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)". Diabetes Metab Res Rev. 36 Suppl 1: e3266. doi:10.1002/dmrr.3266. PMID 32176447 Check |pmid= value (help).
  7. 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.
  8. 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.
  9. 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.
  10. 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.


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