Part 6: Detection and Prevention of Foot Problems in Type 2 Diabetes

2.3 Summary of RecommendationsRecommendations• People with Type 2 diabetes who have peripheral neuropathy should be identifiedbecause they are at risk of foot ulceration and amputation• People with diabetes should be assessed regularly for peripheral vascular disease• People with diabetes who have had a previous amputation are at high risk of ulcerationand further amputation and therefore require regular and frequent review• People with diabetes should be assessed regularly to detect foot deformities including:• Hallux deformities• Hammer or claw toes• Callus• Charcot’s foot• People with diabetes and a current foot ulcer are at high risk for amputation andpreventative interventions to lower that risk should be instituted promptly• People with diabetes and a history of a healed previous diabetic foot ulcer should berecognised as having a life long increased risk of recurrent ulceration and amputation• People with Type 2 diabetes should be routinely assessed with the 10g Semmes-Weinstein monofilament to detect loss of protective foot sensation• People with diabetes should be assessed for peripheral vascular disease by:• enquiring about symptoms of intermittent claudication• palpation of pedal pulses• The routine surveillance for foot problems in people with diabetes should be performedin the following way:• in people without established foot problems, the minimum frequency of footexamination should be once a year• in people with at risk feet but without a current active problem, foot examinationshould be performed every 3 to 6 months• People with diabetes should receive specific footcare education8