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