We require the following information:
- Your medical history
- Your current medications
- Diabetic history and control
- Surgical history
- Specific lower limb issues
- Your most recent blood test results including
- your HbA1c levels
- self-testing blood glucose levels
- kidney function and
- blood pressure.
Bringing all this information with you to the assessment consultation helps us to provide a thorough assessment.
We undertake a visual evaluation of your feet to identify corns, calluses, pressure lesions, deformity or arthritic change that may predispose you to ulceration or indicate a level of motor neuropathy.
Your Podiatrist will undertake a vascular assessment to assess the circulation in your feet. This assessment involves:
- Palpation of the pulses of your feet.
- Doppler machine to assess the rate of flow and magnitude of flow
- Ankle brachial Index machine – assists in assessing macrovascular flow
- Toe brachial Index machine – assists in assessing microvascular flow.
- Visual assessment of skin tone and integrity, hair growth, oedema, varicosities as well as other markers of peripheral vascular health.
A neurological assessment involves:
- Using a monofilament device which is used to check the level of protective sensation. This is an important indicator of your risk of diabetes related foot complications.
- Use a specially calibrated tuning fork to evaluate the response to vibration. This is usually the first marker of neuropathic change and may be accompanied by neuropathic symptoms.
- Other assessments, if indicated, will include reflex check, soft touch, proprioception, and sharp/blunt detection.
A review of your footwear is very important in identifying potential risks of developing pressure areas and future foot issues. We assess the:
- Fit of the shoe
- Style of the shoe – e.g. moccasin, slipper, sandal, ballet flat
- Type of shoe – e.g. walking shoe, hiking shoe, dress shoe, sports specific shoe
- Material – e.g. leather or synthetic upper and soling
- Wear patterns – this can alert us to mechanical issues with walking
- Lace-up versus slide on styles.
This assessment involves checking your joints and muscle range of motion as well as assessing your walking style to identify potential high load areas which can lead to pressure areas and ulceration.
A Biomechanical Assessment involves:
- Gait assessment – viewing your walking style
- Muscle strength
- Muscle flexibility
- Joint range of motion
A full report of your assessment is provided to your referring practitioner, endocrinologist and by request to yourself.
It is important to understand your risk of developing diabetes foot related complications. By understanding your risk level, we are able to educate you in strategies to minimise development of complications.