The Diabetic Foot

Question 1

What test is used to see if someone has peripheral neuropathy?

Answer 1

Monofilament test

Question 2

What is the most common site of ulcers on the foot?

Answer 2

Ball of the foot

Question 3

What three arms of neuropathy are involved in causing foot ulceration and how are they involved? Motor
Sensory
Autonomic

Answer 3

Motor– causes imbalance between extensors and long plantar flexors causing an abnormal shape of the foot. This means there will be increased pressure being applied on the ball of the foot and knuckles ofthe toes.
Sensory

Autonomic– can lead to abnormal blood flow (increase pulse pressure in the foot). It also reduces sweating, which normally protects the foot from minor disease.

Question 4

What effect can sugar binding to haemoglobin have on the feet?

Answer 4

Makes the tendons less flexible – limits joint mobility

Question 5

What are the three types of diabetic feet?

Answer 5

Neuropathic Foot

Ischaemic Foot

Neuro-ischaemic Foot

Question 6

Describe the neuropathic foot. Where is the most common site of ulceration in these feet?

Answer 6

Numb

Warm (because blood flow isn’t regulated properly)

Dry

Palpable foot pulses

Ulcers – at points of high-pressure loading

Question 7

Describe the ischaemic foot. Where is the most common site of ulceration in these feet?

Answer 7

Cold

Pulseless

Ulcers – at foot margins

Question 8

What is Charcot foot?

Answer 8

The neuropathy leads to joint overuse and misuse

This leads to bones losing their normal articulations

The abnormal foot shape makes it at extreme risk of ulceration

Question 9

What can ulceration of the foot lead to?

Answer 9

Osteomyelitis