Diabetic foot history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
History and Symptoms
Dermatologic Assessment
- Visual inspection of the skin: peeling skin, maceration, fissuring between toes
- Skin temperature: Should be warm at the tibia cold at distal toe .
- Look for deformities, charcot foot, hammer toe, and heels.
Vascular Assessment
Pulses: Bilaterally, dorsalis pedis, posterior tibialis, popliteal and superficial femoral. ABI measurement:
- Normal 1-1.3
- Non compressible calcified >1.3
- Stenosis <0.9
- Advanced ischemia <0.4
Arterial oxygen supply could also be measured by transcutaneous oxymetery
Neuropathy Assessment
Symptoms including burning, pin, needles, at early stages
Using neuropathy symptoms score (NSS)[1] and neuropathy disability score (NDS),[2]. Almost half of the patients with diabetes have some level of neuropathy prior to diagnosis. the physician should assess;
- Muscle strength and tone
- Temperature
- Sensation
- Light touch
- Filament nerve conduction studies
- Quantitative sensory testing and autonomic testing.
References
- ↑ Meijer JW, Smit AJ, Sonderen EV, Groothoff JW, Eisma WH, Links TP (2002). "Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score". Diabet Med. 19 (11): 962–5. PMID 12421436.
- ↑ Daousi C, MacFarlane IA, Woodward A, Nurmikko TJ, Bundred PE, Benbow SJ (2004). "Chronic painful peripheral neuropathy in an urban community: a controlled comparison of people with and without diabetes". Diabet Med. 21 (9): 976–82. doi:10.1111/j.1464-5491.2004.01271.x. PMID 15317601.