Diabetic Foot care Recommendations
"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 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. (Level of Evidence: B)" |
"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. (Level of Evidence: C)" |
"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. (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 arte- rial disease to foot care specialists for ongoing preventive care and lifelong surveillance. (Level of Evidence: C)" |
"8. Provide general foot self-care educa- tion to all patients with diabetes.(Level of Evidence: B)" |