Podiatry (feet)

 

Having diabetes means you are at greater risk of developing foot problems because the condition can reduce blood supply to your feet, causing loss of sensation. You might not notice your foot is sore or injured and healing can be impaired.

You are also at risk of developing foot ulcers and infections. In some cases this can progress to amputations. Every person with diabetes should be encouraged to inspect their feet daily and alert a health professional if there are any concerns.

Most diabetes foot care is provided by the community podiatry team. Those with more complex problems can be seen by our diabetic foot team here at the Macleod Diabetes and Endocrine Centre.

More on what we do

Outpatient clinics are run Monday to Friday by specialist diabetes podiatrists. They provide podiatry care for people with active foot disease, including foot ulceration, infection, charcot foot and post amputation wounds.

Specialist doctors from our diabetes team, as well as doctors from across other departments in the hospital, including vascular and orthopaedics are involved in our foot clinics. We also work with orthotics (who provide specialist equipment, such as footwear) tissue viability, the plaster room and the wider diabetes team.

We are closely linked with our community podiatry service, community nurses and practice nurses/GPs, who will often share care between your appointments here. We also have an inpatient diabetes podiatry service, for those in hospital with active diabetes foot problems. Appropriate follow up is then arranged post discharge.

As a minimum, you should have an annual diabetic foot review by a healthcare professional, to check blood supply and sensation in the feet. From this assessment you should be informed of the risk category of your feet, either low risk, moderate/increased risk or high risk (this is the risk of going on to develop foot ulcers).

The Integrated Diabetes Foot pathway works across primary care (GP surgeries, community nurses and community podiatry teams), through to hospital outpatients clinics and inpatient stays at the RD&E Wonford site.

Treatments

Our team can provide:

  • Assessment, diagnosis and treatment of diabetic foot conditions.
  • Wound care, involving debridement, dressing regimes and management of infection.
  • Assessment and provision of appropriate offloading devices and referral to the orthotics service, for bespoke devices, as required.

Our team

The diabetes foot team is made up of many different teams. Some patients may only see one or two different specialties, others may see multiple specialties.

Diabetes specialist podiatrists:

We provide assessment, treatment and co-ordination of care for active diabetic foot conditions.

Diabetes consultants:

We provide overall medical care of the diabetic foot, particularly around complex antibiotic regimes and diabetes management.

Vascular team:

We help look after patients with diabetes who have impaired blood supply. Surgery may be done to improve blood supply to the lower limb, or to remove infective/devitalised tissue.

Orthopaedic team:

We help to look after patients with diabetes who have bony conditions/deformities. Surgery may be done to correct deformity or stabilise the foot.

Orthotics team:

We are specialists in assessing, measuring and fitting bespoke footwear and insoles.

Tissue viability team:

We are specialists in wound care and dressings.

Lead Diabetes Foot Consultant

Dr Roderick Warren

Senior Diabetes Podiatrist

Laura Brown

Advanced Podiatrist in Diabetes

Zoe Boulton

Diabetes Liaison Podiatrists

Russell Aggett, Samantha Barnbrook, Catherine Vickridge

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Diabetic Foot Clinic, Macleod Diabetes and Endocrine Centre

Contact us

Telephone: 01392 403846

Community services

Our Community Podiatry (click here to visit pages) team are based at Newcourt House in Exeter and provide podiatry services across Exeter, Mid and East Devon, in local clinics and patients own home (for those that are housebound).

Clinics

The Macleod Diabetes and Endocrine Centre is open Monday to Friday 8.30 to 5pm. Diabetic foot outpatient clinics are run by the diabetes specialist podiatrists (step down clinic), on most week days.

Step up foot clinics - where a diabetes consultant works alongside the podiatrist - currently operate twice a week.

Other teams, such as, vascular, orthopaedics, tissue viability and orthotics also regularly join the diabetes podiatrists/consultant for multi-disciplinary foot clinics.

Information for healthcare professionals

Integrated diabetic foot pathway link

Diabetic foot service application form link

More information can be found in the Exeter Diabetes Handbook.

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