Prevention, screening and referral of the diabetic foot in primary care

Neil Baker is a Principal Diabetes Specialist and Research Podiatrist, Ipswich Hospital NHS Trust, Ipswich. Colin Kenny is a GP, Dromore, County Down. Costs associated with diabetic foot complications place an enormous burden upon the health economy, particularly if amputations occur, with associated prolonged inpatient care. There is a very considerable human cost with amputations, as well as pain associated with diabetic ulceration and neuropathy, and an associated significant morbidity and mortality risk for those affected. Robust screening programmes that are integrated with comprehensive and structured foot care pathways may lead to significant reductions in lower extremity amputations. This article provides effective tools for identifying and stratifying the risk of foot ulceration in people with diabetes and signposts referral pathways for people with diabetic foot conditions.