As a diabetic you must look after your feet, and to manage your feet properly it is important to have your feet assessed on a regular basis by a qualified podiatrist.
There are several aspects of a diabetic assessment and below is an outline of the main tests and equipment that you can expect to be performed during your diabetic foot assessment.
Neurological Tests
Monofilament testing
A monofilament is a device that is used to determine if there are any alterations with sensation at different points on your foot.
The monofilament is an important test in identifying if an individual is at risk of not feeling certain trauma to the foot. For example, a cut or burn can easily go unnoticed if there is a loss of sensation.
The podiatrist will record if there are any discrepancies and at which site these are occurring; early stage nerve changes will usually occur towards the toes and may progress up the limb in long standing cases.
Vibration fork
A vibration fork is a metal device used to test a different line of nerve fibres, ones that the monofilament cannot test.
The vibration fork again will be placed at different sites on the foot starting at the big toe. You will be required to determine when the vibration starts and stops on each of the different locations.
It is most common that a decrease in vibration perception is the first sensation to deteriorate in diabetic patients; however, this does not always mean the individual has an increased risk of not feeling trauma, which is why the monofilament test is also performed.
Vascular Tests
Pulses
There are two main pulses in your foot that are routinely checked when you have a diabetic foot assessment. One is found behind the inside of your ankle and the other on the top of your foot.
Pulses may be checked two ways; one by hand, where the podiatrist will check the rhythm, rate and intensity of the pulses and the other with a machine called a Doppler. It’s unusual for a podiatrist not to have a doppler.
The Doppler picks up the blood flow through the artery being studied and creates what is called a waveform, which can be seen on the display screen.
It also allows us to listen to the rate and rhythm of the pulse.
From this, the podiatrist is able to determine how well the blood is getting down to the toes and if any obstructions are present.
Toe Pressure Index
This test is much like when you have your blood pressure taken however the cuff is around your big toe instead of your arm. It sounds kind of funny, but it works.
The idea behind taking a toe pressure is to identify the level of vascular disease present, if any.
Once the test is completed, a numerical value will appear on the screen and this value correlates to different levels of vascular disease and allows the podiatrist to determine healing potential if an injury was to occur. This is extremely serious and it not something to joke about.
These are the four main examinations that will be performed; 2 Neurological and 2 Vascular tests. If further testing is required, other tests may be completed.
Depending on the outcome of the four tests above, the podiatrist is able to place you in a risk category and the risk category will determine how often a foot assessment should be performed, however six to twelve months is most common.
The results from all of our testing are recorded; as diabetes is a long-standing disease and monitoring the progress of these results is very important.
You may also like to read our article Foot self-care for Diabetics for more information on how to manage and prevent foot complications occurring.
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