Diabetes Foot Exam Form - wellnesslifesystemscom 2025

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You should have a foot check once a year, which involves checking the foot for feeling, blood flow and any changes to your foot shape or appearance. Your foot check will show whether you have a low risk, moderate risk or high risk of diabetes related foot problem.
A full Diabetes foot screening involves a thorough vascular assessment of the feet by checking the circulation and assessing the blood flow using a Doppler ultrasound and testing the sensation of the feet to assess for nerve damage.
Using 2 fingers, youll need to palpate the marked areas on the foot the posterior tibial and the dorsalis pedis. This requires experience and practice, and it can take time to feel them. If the foot is warm and well perfused and you can palpate either pulse on each foot, this indicates good blood flow.
Your provider will do a few tests to check your nerves and the feeling in your feet: Monofilament test. You will close your eyes while your provider brushes a soft strand of nylon (a monofilament) over your foot and toes. Tuning fork and vibration perception threshold tests (VPT). Pinprick test. Ankle reflexes.
Annual foot exams assess pulses, sensation, foot structure and function, and nails. They should contact their doctor if they notice a foot problem rather than treat it themselves. Diabetes-related complications can start in their feet and may not cause recognizable symptoms.
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The foot examination should include inspection, assessment of foot pulses, and testing for loss of protective sensation (10-g monofilament plus testing any one of: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold). American Diabetes Association (ADA).
The ideal time to do an exam is after a bath or shower when your feet are clean. You will also want to do the exam in an area where there is plenty of light, so you can see all areas of each foot. To begin, sit in a chair and lift your foot over the opposite leg and inspect the bottoms, tops, and sides of each foot.
Examination of patients feet should include: testing of foot sensation using a 10 g monofilament or vibration palpation of foot pulses inspection of any foot deformity and footwear. risk; ulcerated foot. person. Arrange regular review, 36 monthly, by foot protection team.