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Comprehensive Diabetic Foot Examination
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Presentation of information for a comprehensive diabetic foot examination that is used in conjunction with the exam. Healthcare guide to diabetes and your feet can be obtained at www.drpelto.com

Presentation of information for a comprehensive diabetic foot examination that is used in conjunction with the exam. Healthcare guide to diabetes and your feet can be obtained at www.drpelto.com

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Comprehensive Diabetic Foot Examination Presentation Transcript

  • 1. Comprehensive Diabetic Footcare Examination
  • 2. What is it?• An examination to evaluate and determine risk factors for patient’s with diabetes performed on regular basis based on symptoms. – Diabetes with no risk factors – Yearly – Diabetes with 1 risk factor – 2x a year – Diabetes with 2 risk factors – 3x a year
  • 3. What are the risk factors?• Diabetes with the following – Foot deformity (Bunion, Hammertoe, Equinus) – Skin problems (Ulceration, Athlete’s Foot, Calluses, Fungal Nails) – Poor feeling (Neuropathy) – Poor circulation (Peripheral vascular disease) – Improper shoe gear
  • 4. Initial Information• Last footcare visit • Doctor treating your• Last CDFE diabetes (PCP or• Changes medical Endocrinologist) history • Last date seen• Changes to medications• New foot concerns
  • 5. Fasting Blood Sugar• Fast overnight or don’t eat anything for 8 hours• Draw blood to determine amount of blood sugar
  • 6. Blood Sugar Numbers• Taken at various times during the day with glucometer
  • 7. Hemoglobin A1C
  • 8. What are the risk factors?• Diabetes with the following – Foot deformity (Bunion, Hammertoe, Equinus) – Skin problems (Ulceration, Athlete’s Foot, Calluses, Fungal Nails) – Poor feeling (Neuropathy) – Poor circulation (Peripheral vascular disease) – Improper shoe gear
  • 9. Hammertoes & Bunion
  • 10. Equinus
  • 11. Charcot Foot
  • 12. Skin Problems - Corns & Calluses
  • 13. Skin Problems –Ulcerations and Infections
  • 14. Skin Problems –Dry Cracked Skin
  • 15. Skin Problem – Advanced Wound Therapy• Dermagraft• If a wound does not decrease by 50% in 4 weeks advanced therapies recommended.• Reduces risk of amputation and infection.
  • 16. Skin Problem - Nail Disorders
  • 17. Poor Feeling - Neuropathy• Nerve Fiber Biopsy
  • 18. Poor Circulation - PAD
  • 19. Diabetic Shoes – Preventing AmputationsMost patient’s with DiabetesQualify for a pair of Diabetic Shoes each year. • Partial/Complete Amputation • Previous Ulceration • Pre-Ulcerative Callus • Neuropathy with Callus • Poor Circulation • Foot Deformity
  • 20. Footwear at Home – Preventing Injury• Crocs – wide toe box, seamless interior, silver for antifungal and bacteria and toe cap
  • 21. Diabetic Socks• Seamless• Reduces friction that can lead to ulceration and wounds• Compression socks if have swelling
  • 22. Conclusion• Control blood sugar and Hemoglobin A1C• Dangers of neuropathy and “gift of pain”• Risk Stratification – No Neuropathy – Yearly – Neuropathy – 2 x Year – Neuropathy, PVD and/or deformity – 4 x Year – Previous Ulcer or Amputation – 6 x Year
  • 23. Conclusion• High pressure areas, risks and offloading• Proper foot care (reverse of Pressure Stat)• Daily self-examination and monitoring feet• Review of current medications• Next Exam