What this involves
Examination of symptoms reported by the patient.
Assessment of any deformities of feet.
The pulses in the feet are assessed using a Doppler.
The colour, temperature and condition of the skin are assessed.
The condition of the nails are analysed.
The ankle brachial pressure index is taken.
The 5 nerves that supply the foot are assessed by:
A monofilament to test the protective sensation.
A tuning fork to check vibration sensation.
A neurotip to check patient can distinguish between blunt and sharp.
Cotton wool is used to assess light pressure.
Temperature recognition is tested.
Proprioception is assessed.
Muscle power is analysed.
Why the test is carried out
Diabetes can reduce the circulation and sensation in your feet. Awareness of changes in temperature, and of pain and touch, may all be diminished. As a result, foot problems may occur without you being aware of them, and you maybe a greater risk of developing an infection or joint changes. Early recognition of deteriorating blood or nerve supply and high pressures within the foot when walking is key to preventing serious foot problems developing.
The tests will show if there is a decrease in blood or nerve supply to the feet.
The pressure plate analysis will indicate if there is high pressure taken on small joints in the feet, which can lead to an increased risk of ulceration over these areas. Orthoses may be suggested to reduce the pressure in this area to prevent possible ulceration occurring.
A copy of the diabetic report is sent to the patient’s GP and a copy is given to the patient.
The fee for this appointment is £80. We advise this assessment annually for patients with diabetes.