Diabetes Standards of Care and Resources for Clinicians and Educators

Recommendations for Foot Care

Screening

Note: After completing a comprehensive foot exam, assign a category of risk for each patient. Categories of risk are defined as:

• Obtain history of ulceration, amputation, Charcot foot, angioplasty or vascular surgery, cigarette smoking, retinopathy, renal disease, vascular disease, and assess symptoms of neuropathy (pain, burning, numbness) and vascular disease (leg fatigue, claudication)
• At each diabetes visit, inspect patients' feet for acute problems
• At diabetes diagnosis, and at least annually, perform a comprehensive foot examination to include assessment of:
  • Skin integrity
  • Vascular status including pulses in the legs and feet
  • Foot structure and biomechanics
  • Neurological exam with a 10-g monofilament and at least one other assessment (vibration sensation using a 128-Hz tuning fork, pinprick sensation, or ankle reflexes)
  • Low Risk: normal sensory exams, foot structure, vascular status, and skin integrity, and no prior non-traumatic ulcerations
  • High Risk: abnormalities on exam or a history of non-traumatic ulcerations

Treatment

• Provide risk-appropriate evaluation and monitoring, and refer patients as needed to foot care specialists (podiatrists, wound care specialists), footwear providers, orthopedists, and vascular surgeons.
• Provide self-management education including proper care of the foot, nail and skin care, appropriate footwear, and daily visual inspection of the feet

Featured Foot Care Resources

Foot Care Patient Education Resources