Every 12 months people who have Type 1 & 2 diabetes should have his or her feet reassessed. These results should be compared with the baseline assessment and with the results of 12 months earlier to see if there has been any change, especially if this indicates that there is an increase of risk of foot problems.

The 12 monthly re-assessment we offer examines the most important areas that indicate the immediate risk or the potential of developing problems in the future. Areas covered are:

• Circulation
• Sensation
• Muscle and Joint function
• Dermatological status

The tests and the equipment used have been shown in research to be the best possible to provide you with valid and reliable results.

This information then becomes a baseline for comparison with the results of your regular 6 monthly foot check or 12 monthly foot health reassessment done by us, your regular podiatrist or GP .

We will provide your GP with a report and discuss with you the options if any areas need to be addressed.

1. Assessment of Your Blood Circulation

We use Doppler ultrasound to measure the blood flow velocity (speed), timing and amount over 2 areas in each foot. This gives us the status of the health of your present circulation

We combine this equipment with blood pressure measurement, comparing the pressure between the arm and at the ankle. This gives us an indication of the potential of future problems.

Both of these measurements are objective and thus directly comparable with previous assessments

2. Assessment of the Nerve sensation in your feet

Nerve damage, often called neuropathy, particularly when coupled with high pressure areas, can occur in the long nerve fibers connecting your sense of feeling and pain in your feet, to your brain.

If this sensation pathway is damaged, you might not feel that your feet are sore or injured and infection may result if it is left unnoticed.

We use a monofilament device to assess the sensation in 10 areas on each of your feet. This gives us the status of the health of your present sensation and indicates where any risk of insensitivity may occur.

We also use a specially graduated tuning fork to measure the sense of vibration over 3 bony prominences of each foot. This gives us an indication of the potential of future problems, as vibration sense is the first sense to diminish.

Both of these measurements are also objective and thus directly comparable with previous assessments

3. Assessment of Muscle and Joint Function

One of the risk factors that recent research has shown, is that people with diabetes can often have a decreased range of motion in the joints.

This can increase the pressure under certain areas of the feet which increases the risk of injury to that tissue.

This risk will also be affected by the structural misalignments we all have and how your muscles and joints function.

4. Assessment of Your skin and nails condition

The tone of your skin, development of hard thick skin, (callous), or Infection between the toes, is more than just a nuisance for people with diabetes. These may indicate a more significant concern.

For example, a callous formation, such as seen in this picture, may well indicate high pressure occurring under areas that are not designed to tolerate them. This could lead to tissue injury.

In your assessment, we will thoroughly examine your feet for nail or skin problems. This information helps to build a clear picture so we can recommend strategies, not only to address any immediate concerns, but to actively work towards curing any conditions you may have and prevent them reoccurring.