Foot screening for diabetics.
BACKGROUND
This study aims to evaluate the results of foot screening performed in a study population of 2137 diabetics (3926 feet) screened from 2006 to 2008 by the National University Hospital (NUH) multi-disciplinary team for diabetic foot problems.


METHODS
A standardised protocol was designed. Foot screening consisted of detailed history taking and clinical examination including assessment for sensory neuropathy by Semmes Weinstein monofilament (SWMF) and neurothesiometer and assessment of vasculopathy by ankle-brachial index (ABI) and total body irradiation (TBI). The foot screening was performed by a trained staff nurse. All patients were classified according to King's College Classification.


RESULTS
Majority of the patients were in the fifth (27.9%) and sixth (30.0%) decades of life. Two thousand sixty-four had type II diabetes, and only 73 had type I diabetes. Neuropathy was found in 1307 (33.3%) feet based on 5.07 SWMF. Vasculopathy was recorded in 510 (13.0%) and 546 (13.9%) feet based on ABI <0.8 and TBI <0.7. According to King's Classification, 1069 (50.0%) were Stage 1: Normal and 615 (28.8%) were Stage 2: At-Risk.


CONCLUSIONS
Foot screening should be performed as early as possible to detect "At-Risk" feet and prevent the development of diabetic foot complications, thereby further reducing the risk of major amputations.
Nather
Aziz
A
Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. dosnathe@nus.edu.sg
Chionh
Siok Bee
SB
Tay
Patricia L M
PL
Aziz
Zameer
Z
Teng
Janelle W H
JW
Rajeswari
K
K
Erasmus
Adriaan
A
Nambiar
Ajay
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D017719:Diabetic Foot / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D055815:Young Adult