We assess your neurovascular status as part of determining your overall diabetic foot risk status. This, in turn, helps us to guide regular treatment intervals if required or to provide advice if it is deemed safe for you to continue to manage your own feet at home.
In order to assess someone’s neurovascular status, we look at two things: neurological assessment and vascular status. High, uncontrolled blood glucose levels are known to cause peripheral neuropathy – nerve damage in the peripheries such as the feet or hands, as well as damage to vascular walls. Over time this can lead to the development of foot ulcers that have difficulty in healing due to the reduced blood flow. Our role as a podiatrist is to determine and manage an individual’s risk status to assist in preventing these issues from happening.
As part of the neurological assessment we use both a 10g monofilament and a 128Hz tuning fork to look at what is known as ‘protective sensation’. Reduced protective sensation in the feet increases the risk of development of ulcers due to a reduction in feeling, and therefore someone can step on something sharp and not know about it.
For the vascular assessment we palpate pedal pulses and assess them on an ultrasound known as a doppler. The waveform and sound shown on the doppler helps us to determine whether the quality of the blood flow in the feet.
At a minimum, it is recommended that you have an annual diabetes assessment with your podiatrist to assess and monitor your risk status. Over time your risk status may change and it is important to be aware of these changes to best reduce your risk of diabetes-related foot complications.