There is a difference between treating a diabetic foot problem and preventing one. By the time there is a wound, the hard part has already started. Most of what matters happens well before that, and it is why we assess feet the way we do.
What a comprehensive diabetic foot assessment involves here
A comprehensive assessment goes further than checking that a pulse is present. We use a handheld Doppler and listen to the sound of the blood flow, because the sound carries information that feeling for a pulse does not. If required, we may also measure systolic toe pressures. Alongside the circulation we check sensation, skin and nail condition, footwear, and the pressure areas where problems tend to begin.
How often the diabetic foot assessment should be performed
We carry out the assessment at any first appointment, whether or not you have diabetes, so that there is a baseline to work from. After that, how often it is repeated depends on your risk rather than on a standard schedule.
We work to the risk categories set out in the International Working Group on the Diabetic Foot (IWGDF) guidelines. They are guidance rather than rules, and your podiatrist will confirm what is right for you.
- No problems to date. Once a year.
- Some concern in the past, or previous treatment. Twice a year.
- A previous wound, a previous amputation, or neuropathy. Four times a year.
Being seen and being assessed are not the same thing. You may come in more often than this for routine care. This is about how often the full assessment is repeated.
Your risk category is not fixed. It can move in either direction, and reviewing it is the point of coming back.
We write back to your GP
If you come to us on a chronic disease management plan, we write to your GP with what we found and what we recommend, including whether you need further arterial assessment or a referral to a vascular surgeon. Foot care for someone with diabetes works better when the people looking after you are talking to each other.
Why this practice works this way
Both of our podiatrists have practised in the High Risk Foot Service at a leading Sydney tertiary hospital, where complex diabetes-related and wound problems are managed. Between them they have over twenty-five years in practice.
That is where the emphasis on prevention comes from. It is also why, if something does go wrong, we know where to refer and how quickly it needs to happen.
Booking
If you have diabetes and have not had a foot assessment in the last twelve months, book a comprehensive diabetic foot assessment. You can book online or call (02) 9868 6177.