Across the ditch: the collective diabetic foot assessment

Abstract

Results Fifty three (n=53) Māori patients were recruited for this study with a median age of 54 years (IQR: 45.5 – 61.5 years). We found that Māori had a median duration of diabetes for 15 years, were obese (median body mass index 35.7) with sub-optimal glycaemic control (HbA1c >8% 42%). Podiatric specific characteristics revealed good arterial flow (IQR: Right ankle-brachial index dorsalis pedis 1.1) and a median neuropathy score of 2 (IQR 0, 4). Half the cohort displayed restriction in movement of the right ankle joint (n= 31) and first metatarsophalangeal joints (n=29). Foot education was favourable with positive benefits such as daily foot inspection (n=52). Using a modified classification tool which targets the risk factors collectively, thirty two (60%) patients were identified as requiring regular podiatry management. Conclusions A standardised evidence-based screening and assessment tool could be widely applied by primary care health podiatrists in the detection of imminent diabetes-related foot pathology and to support disease management. This collective assessment would be of particular benefit to communities, including Maori; where the incidence of diabetes and its complications is higher.