Diabetes guidance 1766.pdf - East Cheshire NHS Trust

Foot assessmentAll patients require an annual assessment including:• Symptoms – claudication, pain, history of ulcer• Inspection – callus, deformity, presence of ulcer• Examination – skin condition, pulses present, sensitivity to 10g pressure, vibration perception.Note the use of heel balm (e.g. Dermatonics, Flexitrol) may be appropriate for those with very dry skin.Categorise into risk groups for follow up as per table.Risk Category Indicators of Risk Category ManagementLow current risk Normal sensation and Annual review by primaryPalpable pulses andcare teamNo current or previous ulcers and No podiatry input requiredNo deformity andNo skin changes andNormal visionIncreased Risk Neuropathy or Annual review by primaryAbsent pulses orcare team andPrevious vascular surgery orRefer patient for regularSignificant visual loss orpodiatry input (3 to 6 monthlyCannot reach own feetreview)High risk Neuropathy or Absent pulses AND Annual review by primarySkin changes or Deformity orcare team andPrevious ulcerRefer patient for regular podiatrycare (1 to 3 monthly review)