Lesson 1Screening for comorbid contributors: footwear assessment, mobility, nutritional status, smoking cessation importanceAddresses comorbid contributors to ulcer risk, including footwear, mobility, nutrition, and smoking, with practical screening methods and strategies for counselling, referral, and multidisciplinary support to optimize outcomes.
Footwear fit, insole wear, and offloading needsAssessing gait, balance, and mobility aidsScreening for malnutrition and weight extremesSmoking assessment and cessation counselingCoordinating referrals to allied health servicesLesson 2Neurological exam: monofilament testing, vibration with tuning fork, pinprick, proprioception, reflexes; interpretation and grading of peripheral neuropathyDescribes structured neurological examination of the diabetic foot, including monofilament, vibration, pinprick, proprioception, and reflexes, with grading of peripheral neuropathy and implications for ulcer risk and management.
Performing 10 g monofilament testing correctlyVibration testing with tuning fork and devicesAssessing pinprick, temperature, and proprioceptionAnkle reflex testing and interpretationNeuropathy scoring systems and risk linkageLesson 3Risk stratification for diabetic foot (IWGDF/International guidelines): categorization and implications for follow-upExplains risk stratification using IWGDF and related guidelines, detailing categories based on neuropathy, PAD, and deformity, and linking each risk level to follow-up intervals, education needs, and preventive interventions.
Core components of diabetic foot risk assessmentIWGDF risk categories and clinical criteriaLinking risk level to follow-up frequencyPreventive strategies by risk categoryPatient education tailored to risk statusLesson 4Detailed foot inspection: skin, callus, ulcer characteristics (location, size, depth, exudate), infection signsDetails systematic visual and tactile inspection of the diabetic foot, including skin, nails, deformity, callus, and ulcer features such as location, depth, exudate, and infection signs, to support diagnosis and treatment planning.
Structured inspection of skin, nails, and deformitiesCharacterizing ulcer location, size, and depthAssessing wound bed, exudate, and odor qualityIdentifying local and spreading infection signsEvaluating callus, pressure points, and footwearLesson 5Vascular assessment: palpation of dorsalis pedis and posterior tibial pulses, ankle-brachial index (ABI), toe pressures and transcutaneous oxygen pressure (TcPO2) basicsCovers bedside vascular assessment of the diabetic foot, including pulse palpation, ABI, toe pressures, and TcPO2, with interpretation limits, pitfalls in diabetes, and implications for referral and revascularization planning.
Palpation of dorsalis pedis and posterior tibial pulsesUsing handheld Doppler to augment pulse assessmentABI technique, interpretation, and diabetic pitfallsToe pressure and TcPO2 basics and clinical thresholdsWhen to refer for vascular imaging or interventionLesson 6Red flags indicating urgent referral: rapidly spreading infection, exposed bone, signs of ischemia, systemic infection signsExplains clinical features that demand immediate referral, focusing on rapidly spreading infection, ischemia, systemic compromise, and exposed bone, with guidance on triage, stabilization, and communication with higher-level care.
Recognizing rapidly spreading soft tissue infectionIdentifying exposed bone and suspected osteomyelitisClinical signs of acute limb ischemia and necrosisSystemic toxicity: sepsis, SIRS, hemodynamic changesStabilization and referral pathways for emergenciesLesson 7Documentation and photography standards for ulcers and serial monitoringOutlines standards for documenting diabetic foot ulcers, including required descriptors, validated classification systems, and high-quality clinical photography to enable serial monitoring, audit, and multidisciplinary communication.
Essential elements of ulcer clinical notesUsing Wagner and University of Texas gradingMeasurement methods and mapping ulcer locationPhotography technique, positioning, and lightingSerial comparison and secure image storageLesson 8Targeted medical history for diabetic patients: duration, glycemic control, medications, smoking, prior ulcers/amputations, renal/cardiovascular diseaseFocuses on targeted history in diabetic patients with foot risk, including diabetes duration, glycemic control, comorbidities, prior ulcers or amputations, lifestyle factors, and medications that influence healing and infection risk.
Key diabetes history: duration and complicationsAssessing glycemic control and hypoglycemia riskDocumenting prior ulcers, amputations, and traumaReviewing medications affecting healing and flowLifestyle factors: smoking, activity, and self-care
