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Risk classification based on the comprehensive foot examination

Risk classification based on the comprehensive foot examination
Risk category Definition Treatment recommendations Suggested follow-up
0 No LOPS, no PAD, no deformity Patient education including advice on appropriate footwear. Annually (by generalist and/or specialist)
1 LOPS ± deformity Consider prescriptive or accommodative footwear. Every 3 to 6 months (by generalist or specialist)
Consider prophylactic surgery if deformity is not able to be safely accommodated in shoes. Continue patient education.
2 PAD ± LOPS Consider prescriptive or accommodative footwear. Every 2 to 3 months (by specialist)
Consider vascular consultation for combined follow-up.
3 History of ulcer or amputation Same as category 1. Every 1 to 2 months (by specialist)
Consider vascular consultation for combined follow-up if PAD present.
LOPS: loss of protective sensation; PAD: peripheral arterial disease.
Reprinted with permission from: Boulton AJM, Armstrong DG, Albert ST, et al. Comprehensive Foot Examination and Risk Assessment: A report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care 2008; 31:1679. Copyright ©2008 American Diabetes Association.
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