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Clinical

Managing the diabetic foot

The feet of diabetics are at risk of ulceration. Suneeta Kochhar
discusses assessment and prevention in these patients.

The diabetic foot is defined as being at risk of ulceration if neuropathy, ischaemia, deformity, callus or swelling is present.1 An ulcerated foot is at risk of infection, cellulitis and necrosis, which can result in amputation. Identifying patients at risk of an ulcer allows intervention by a multidisciplinary diabetic foot team and reduces the risk of complications developing.1,2

Assessing the diabetic foot

Up to 40 per cent of diabetics have asymptomatic neuropathy which increases the risk of developing an ulcer.3 Motor neuropathy may result in a high medial longitudinal arch and prominent metatarsal heads creating pressure points over the plantar forefoot. Abnormal foot posture may be related to muscle weakness and wasting, which will be discovered during neurological examination.3

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