2014糖尿病指南: 足保护Foot Care

2014糖尿病指南: 足保护Foot Care

All patients with diabetes

• Annual foot exam to identify risk factors predictive of ulcers and amputations
• Exam to include: inspection, assessment of foot pulses, LOPS testing
• Provide foot self-care education

Patients with foot ulcers, high-risk feet (previous ulcer or amputation)
  - Use multidisciplinary approach

Refer to foot care specialist
   • People who smoke
   • LOPS and structural abnormalities
   • History of prior lower-extremity complications
     Lifelong surveillance

Include in initial PAD screening
   • History for claudication and assessment of pedal pulses
   • Obtain ABI

Refer for further vascular assessment
    • Patients with positive ABI, significant claudication
    • Consider exercise, medications, surgical options

ABI=ankle-brachial index; LOPS=loss of protective sensation; PAD=peripheral arterial disease