Foot complications are a major cause of morbidity and mortality in persons with diabetes, and contribute to increased healthcare utilization and spending1-4. Statistically speaking, persons with diabetes5:
  • Have a 15-25% lifetime risk of foot ulceration
  • Are 15-40 times more likely to require a lower limb amputation compared to the general public
  • Have a five year mortality rate of 50% post lower-limb amputation, which is a higher rate of mortality than in seen in breast cancer in females or prostate cancer in males6

Approximately 85% of amputations are preceded by a foot ulcer5. The good news is that foot ulcerations and their associated complications can be prevented in part by regular foot screening, risk stratification and timely referral to indicated members of the integrated healthcare team.

The purpose of this tool, is to guide you, as a healthcare professional, in building your patients ‘dream team’, as it relates to their level of diabetic foot risk. To use this tool you must have already assessed your patient’s feet using a validated diabetic foot screening tool and determined their level of risk using the International Working Group on the Diabetic Foot’s (IWGDF) Diabetic Foot Risk Classification System.

Have you completed a foot screen and determined your patient’s level of risk?

NO

To use this tool to build your patient’s diabetic foot ‘dream team’ you must have screened their feet using a valid diabetic foot screening tool and then determined their risk level (low, moderate or high) using the International Working Group on the Diabetic Foot’s (IWGDF) Diabetic Foot Risk Classification System. If you do not already have access to a validated diabetic foot screening tool or to the IWGDF’s Diabetic Foot Risk Classification System, please click on the associated PDF icons below.

NOTE: Tools are only useful if they are evidence-informed, relevant to the characteristics of the target population and if clinical education and organizational and systemic supports are in place7-8
 

Once you have completed your risk assessment and stratified your patient’s risk as either low, moderate or high (stratification depends on the assessment tool you used and its individual instructions), proceed to the “YES” area below.

YES

Great! You have used a valid diabetic foot screening tool and risk stratification system and have determined your patient’s level of diabetic foot risk (low, moderate or high). Using the dial below, please indicate your patient’s level of diabetic foot risk to proceed with building their diabetic foot ‘dream team’.
Low-Risk:
  • IWGDF risk category 0
  • Intact sensation (absence of sensory neuropathy) AND
  • Intact skin (absence of any current ulcerations and no history of diabetic foot ulcerations or foot amputations) AND
  • Adequate blood flow to the lower limbs
  • May or may not have a bony/structural foot deformity
Medium-Risk:
  • IWGDF risk category 1, 2a, 2b
  • Loss of protective sensation, absence of a bony/structural foot deformity, absence of peripheral arterial disease (PAD) and intact skin, OR
  • Loss of protective sensation PLUS a bony/structural foot deformity, absence of PAD and intact skin, OR
  • Presence of PAD and intact skin
High Risk Foot:
  • IWGDF risk category 3a or 3b
  • Current or previous history of diabetic foot ulceration AND/OR
  • Previous history of amputation

     

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