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Tool ranks risk for diabetic foot ulcer

Patients at risk of diabetic foot ulcers can be easily prioritised for care using a newly validated risk tool.

The tool, shown below, is based on assessment of foot responses and medical history. It is designed for use by GPs and stratifies patients at low, moderate or high risk to prioritise them for referral. It scores highly for both sensitivity and specificity, the researchers report.

Study leader Dr Graham Leese, consultant in diabetes at Ninewells Hospital in Dundee, said: 'The purpose is to direct those with greatest need to the scarce podiatry resources. It's been very useful for GPs, and more so to practice nurses in determining what level of care a patient needs.'

Under the risk tool, 29.4 per cent of those classed as high-risk developed ulcers, compared to 2.3 per cent of moderate-risk and 0.4 per cent of low-risk patients.

The researchers said low-risk patients should be instructed on self-care, moderate-risk patients should be referred to podiatrists and high-risk patients to podiatrists with an interest in diabetes.

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