Care of my feet
Diabetic foot screening is usually carried out annually by a Practice Nurse who has had training in foot assessments.
The National Institute for Clinical Excellence (NICE) have produced a guideline for prevention and management of foot problems in type 2 diabetes which states that as part of this review you should expect to have your feet examined for any skin changes or deformity, check that footwear suits the foot shape and the blood supply and nerve supply should be checked.
To assess the circulation the nurse will feel for pulses on the top of your foot and the inside of the ankle.
The nerve supply is tested using a plastic filament (monofilament), which applies a measured amount of pressure to the skin to check you have enough feeling to protect your feet from damage.
If you have poor circulation or reduced feeling in your feet you will be referred to podiatry to have your feet assessed further for peripheral vascular disease or peripheral neuropathy.
Role of Podiatry
All people with diabetes can refer themselves to NHS podiatry service, which covers Portsmouth City and South Hampshire cluster.
Any health professional can refer someone with diabetes if they feel this to be necessary. This can be for assessment and treatment of existing foot conditions, advice as well as for diabetes related issues.
All podiatrists will treat people with diabetes but in each health centre/clinic there will be a diabetes advanced practitioner with specialist training and skill in treating diabetes foot disease – referrals should be made to these podiatrists where appropriate.
Once a Diabetic Foot Assessment (DFA) has been completed in primary care, referrals can be made to the podiatry service according to the foot condition.
Personal Foot Care Advice
Daily visual checks – Look for any new injury and seek help if concerned·
Daily skin care – Wash and dry carefully. Apply moisturiser to areas of dry skin
Nail Care - Best attended to frequently as part of foot care routine. Cutting nails may be difficult and it is possible to damage the skin. Weekly filing is the safest and easiest way to deal with toenails
Footwear - Should fit well and be foot shaped. Shoes with adjustable fastening are best.
Remember - if you have sensation loss you may not notice minor trauma. Be careful with hot water bottles or barefoot walking.
Tight footwear or hosiery could be harmful.
Wearing thicker socks/stockings to keep warm in winter may make shoes too tight. Shoes should not need to be worn in