Diabetic foot ulcer
Annual Visual Inspection and Identification of the Foot at Risk
The IDF (2005) and the National Institute for Clinical Excellence3 in the United Kingdom recommends that all people with diabetes should have an annual visual assessment of their foot which should include assessment of the patient’s sensation (neuropathy) blood flow and other risk factors for ulceration such as foot deformity or areas of callus (hard skin) build up. Following examination of the foot, each patient can be assigned to a risk category, which should guide subsequent management. Click on the link below for an example of a risk classification framework.
Leese4 undertook an evaluation of risk stratification on a model similar to the framework above. They risk stratified 3526 patients and found that ulceration was 83 times more likely in high risk group 6 time more likely in medium risk group and reassuringly 99.6% probability of low risk patients NOT developing a foot ulcer