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Diabetes mellitus
Diabetic peripheral neuropathy

Low risk
  • Education
  • Annual review

High risk

  • Painless
  • Callus
  • Warm
  • Limited joint meovement
  • Prominent MT heads
  • Charcot
 No complications
  • Special education
  • Regular chiropody for callus 6-8 weekly
  • Footwear assessment
Complications
  • Foot ulcer management
    • Consider referral
    • Regular chiropody
    • Reduce pressure
    • Antibiotics
  • Charcot
    • Refer if hot/slightly painful
    • Bone scan (90% specific)
  • Neuropathic oedema (rare)
    • Exclude cardiac factors

 

Source: Northumbria NHS Health Care Trust diabetes protocol