Diabetic foot Flashcards
What complications of diabetes predispose to foot disease?
Neuropathy
Peripheral vascular disease
What is diabetic foot the most common cause of?
Foot amputation
What percentage of NHS bed occupancy is due to diabetes related problems?
10% (50% foot disease)
How does the monofilament test work?
When the filament bends, you have applied 10g of pressure and a normal foot will feet 10g- the test is normally performed on the ball of the foot
Why is the ball of the foot normally tested in the monofilament test?
The most common site at which ulcers are found and 50% of new foot disease starts at the ball of the foot
Which nerve in the body is the most susceptible?
Sensory nerve to our big toe because it is the longest in the body
What is the pathway to foot ulceration?
Motor neuropathy Limited joint mobility Autonomic neuropathy Trauma- repeated minor/discrete episode Sensory neuropathy Peripheral vascular disease Reduced resistance to infection Other diabetic complications
What does motor neuropathy cause?
An imbalance between the extensors and the long plantar flexors causing an abnormal shape in the foot which leads to increased pressure being applied on the ball of the foot and the knuckles of the toes
What can autonomic neuropathy lead to?
Abnormal blood flow in the foot and reduced sweating which normally protects foot from minor disease
What are the 3 types of foot ulceration?
Neuropathic foot
Ischaemic foot
Neuro-ischaemic foot (combo)
How does a neuropathic foot present?
Warm because blood flow isn’t regulated
Dry
Numb
Ulcers at points of pressure
How does ischaemic foot present?
Cold
Pulseless
Ulcers at foot margins
What sort of preventative management is there for diabetic foot?
Prevent hyperglycaemia Prevent hypertension Prevent dyslipidaemia Stop smoking Education
What specific foot care measures are there?
Inspect daily Have feet measured when buying shoes Buy shoes with square toe box and laces Inspect inside of shoes Attend chiropodist Cut nails straight Care with heat Don't walk barefoot
What is Charcot foot?
It is described as rocker bottom foot- bones in feet are articulated in an abnormal way so the foot is in a position that would be painful in someone that isn’t diabetic but is painless in diabetics
