In Australia, there are 10 000 hospital admissions each year for diabetic related foot ulcerations. Diabetes can damage the nerves in the lower limb and foot (peripheral neuropathy) and affect the circulation in both lower limbs (peripheral vascular disease (PVD)). These two factors significantly increase the risk of foot ulceration or infection. According to statistics from Diabetes Australia, peripheral neuropathy affects approximately 13% of Australians with known diabetes and 14% with peripheral vascular disease.

Symptoms for peripheral neuropathy include numbness, tingling, burning pains. Symptoms for PVD can include sudden cramping in the legs after short distances, sharp pains in the feet whilst in bed at night and cold feet. Sometimes however peripheral neuropathy and PVD can occur with no associated signs and symptoms, meaning that the patient is unaware of the greater risk that they have for developing diabetic related foot ulceration or infection.

At South East Sydney Podiatry we perform a thorough diabetic foot assessment. We use specialised instruments to examine the presence of PVD and/or the presence of peripheral neuropathy, as well as examining other risk factors for developing diabetic related foot complications. During a diabetic foot assessment a Doppler arterial ultrasound is performed on the two main arteries that supply each foot. This is completely painless and completely safe. In some cases the systolic blood pressure in the big toe is assessed using a photoplethysmography (PPG) unit. This is very similar to measuring the blood pressure in your arm but in fact it assesses the blood pressure in your big toe with slightly more specialised equipment. At the end of the assessment advice is given on ways to manage your feet and prevent complications. This is tailored to each individual depending on the results of the assessment.

Usually this thorough diabetic foot assessment and Doppler arterial ultrasound is examined every 6-12 months if you are a "low risk" diabetic patient. It may be assessed more often if you have a current diabetic related foot complication, or are assessed as having a high risk of complications..

This is the Doppler arterial ultrasound machine used during a diabetic foot assessment.

This is an ulceration- What podiatrists aim to prevent!!!