Diabetes foot


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org];

Overview
1 in every 4 patients with diabetes develops complications. The pathogenesis of diabetics foot is due to two causes i.e. neuropathy and vasculopathy. Due to neuropathy the patient loses sensation whereas, vasculopathy causes poor blood supply to the foot region. Due to both these contributing factors, even a small trauma to the feet can give rise to ulcer or gangrene and may even require amputation. Thus, foot examination by a podiatrist or a doctor is recommended every year.

Inspection

 * Dilated veins
 * Scar, Sinuses
 * Shiny skin
 * Hair distribution
 * Areas of Pigmentation
 * Areas of discolouration
 * Varicose vein
 * Ulcers
 * Brittle or broken nail
 * Fungal infection

Palpation

 * Temperature (increase temperature- deep vein thrombosis, decrease temperature-ischemia)
 * Tenderness (squeeze calf muscle and achilles tendon for tenderness)
 * Pulsation- Dorsalis pedis
 * Capillary filling time
 * Ulcers in pressure areas like ball of great toe, base of fifth metatarsal, posterior aspect of heel

Motor examination

 * Nutrition/Bulk
 * Tone
 * Power
 * Reflexes

Sensory

 * Vibration
 * Joint position sense

Video: Physical examination diabetes


Video: Diabetic foot care
