Introduction

• All patients with diabetes should have their shoes, socks and dressings removed and their legs and feet carefully assessed on admission for evidence of vascular compromise, ulceration, active foot infection and acute Charcot arthropathy.

• Patients with diabetes are at higher risk of pressure damage (due to neuropathy) and should have daily feet/heel examination and pressure relief if required

• Staff should know the Emergency Diabetes Foot Referral Pathway for their hospital

• If you identify a diabetes foot emergency refer immediately to the appropriate team (vascular SpR on-call).

Identification

It is vital to recognize the signs of sepsis/infection if a patient is admitted with a diabetes foot emergency and initiate prompt antimicrobial treatment according to local guidance:

• Antimicrobial Guidelines for the Empirical Management of Diabetic Foot Infections

Recognising patients with diabetes who are at risk of foot ulceration. The document below indicates which patients with diabetes are at risk of developing foot ulceration:

• Footcare Pathway

Patient information leaflets are available
Foot care for low, high risk feet and diabetes foot ulcers

• Low Risk

• Moderate Risk

• High Risk

• Diabetes foot ulcers

Useful Links

• NICE Guidance (NG19) : Diabetic foot problems: prevention and management 

• Diabetes UK position statement:  Putting Feet First: preventing amputations and improving foot care for people with diabetes