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Annual foot exams recommended at intervals for people with diabetes
by a physician or foot care trained
Performed by an advanced care provider
The frequency of examinations should be based on the patient’s anticipated risk of foot disease, but should be done at least annually. A history of foot ulcers or amputations and a history of poor vision should be evaluated.
Tests to be performed include: neuropathy examination (Semmes Weinstein monofilament test) and palpation of the foot pulse; assessment of foot deformities (hammertoe, bunion, Charcot’s deformity), including pressure points and crust formation. Examination of the toes, including interdigital cracking, calluses, and nail problems.
Important factors to note include the patient’s current foot care, how often it is done, and what all is done. Basic education on foot care is recommended and reinforced regularly.
Patients at increased risk (presence of neuropathy, ischemia, structural deformities) should have more frequent foot exams and increased education. Measurement of toe blood pressure can help predict not only the likelihood of wound healing, but also the risk of ulceration.