Well equipped Podiatry department/Foot Care
DOPPLER STUDY
Assessment of peripheral vascular flow, which can be asymptomatically decreased in diabetics.
Calculation of Ankle-Branchial index (ABI) will also be done.
This instrument provide information about blood velocity, blood pressure and vascular images.
Vibration Perception Test
The diagnosis of neuropathy is an important consideration in determining if a foot is particularily vulnerable to painless injury, leading to chronic and spreading ulcer. This has terminal consequences and could lead to high level amputations.
Conventional assessment of neuropathy with cotton wool, vibrating tuning fork, pinprickle and hot and cold sensation give qualitative diagnosis. It is necessary to decide quantitatively how deficient the protecting sensations have become to help decide the incremental risks the foot is at with diminishing sensations and increasing threshold.
The vibrometer Vibration perception test (VPT) helps us, if used properly and with due precautions, to establish this threshold in the form of vibration perception threshold. This is done by applying a vibrator that gives minute last normally detectable vibration, in the foot. The failure to detect the same can be quantitatively to decide the incremental risks.
Hot perception test / Cold perception test (HPT/CPT)
The loss of nerve fibers in diabetic neuropathy is neither uniform nor simultaneously. The damage to small thinly myelinated and unmyelinated nerve fibers is usually the beginning. This results in diminishing thermal and pain sensation. Hot perception test/Cold perception test (HPT/CPT) helps in detecting diabetic polyneuropathy at an early stage.
Pedography
The pressure picture of the neuropathic diabetic patient can be influenced by foot deformities and incorrect foot function. In any case, the specific foot regions with higher pressures indicate greater risk for tissue breakdown. Pedography may aid early detection of deformed feet and malfunction. In addition to the standard therapy for diabetic patients, an altered load on the foot with localized high pressures may require immediate foot treatment with appropriate footwear and pressure relieving orthotics. Under no circumstances should these individuals walk barefoot because plantar pressures will increase dramatically and the foot is left unprotected. Shoes and orthotics should be fabricated by a trained professional. The 1:1 hardcopy of the pedography platform measurement provides a baseline for the construction of the shoe insert. The patient can then be measured inside the modified shoe for quantification of the load.In-shoe pressure distribution measurement systems were designed for that purpose.