Diabetic Foot care Recommendations

2016 ADA Guideline Recommendations
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Microvascular Complications and Foot Care Diabetic Kidney Disease Diabetic Retinopathy Diabetic Neuropathy Diabetic Footcare
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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)"