Preventing Diabetic Foot Complications : Strategic Recommendations

Abstract

The diabetic foot is the commonest cause of non-traumatic lower extremity amputation in the developed and developing nations. Several risk factors predispose the diabetic patient to foot ulceration and peripheral neuropathy, with peripheral vascular disease are the commonest risk factors. Clinical examination for these risk factors is often inadequate, reasons for the low performance often hinging on the huge patient turnouts in most diabetic units, the cumbersomeness of and time delays associated with detailed clinical assessments and the subjective and sometimes poorly reproducible results associated with these assessments.

Aesthesiometry, Bio-Thesiometry and hand-held Doppler ultrasound techniques are quantitative, non-invasive, rapid, reliable and reproducible methods to detect sensory neuropathy and peripheral vasculopathy. Their objectivity and ease of performance make them ideal for mass screening programs.

This article recommends a four model risk selection criteria to target diabetic patients at highest risk for foot complications, such that specific preventive programs focus on this group at highest risk and so reduce rate of loss of limbs to diabetes.

Key words: Diabetic foot, diabetes mellitus, peripheral neuropathy, loss of protective sensation, vibration perception threshold.

Journal of College of Medicine Vol.10(1) 2005: 10-14