Table 1 The University of Texas Diabetic Foot Risk Classification System (adapted from [14])
Category 0: Minimal Pathology | Category 1: Insensate Foot | Category 2: Insensate Foot with Deformity | Category 3: Demonstrated Pathology |
NO Neuropathy | Neuropathy NO Deformity | Neuropathy with Deformity | History of Pathology |
• Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. |
• Protective sensation intact (Semmes-Weinstein 10g monofilament detectable). | • Protective sensation absent (Semmes-Weinstein 10g monofilament NOT detectable). | • Protective sensation absent. | • Protective sensation. |
• Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. | • Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. | • Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. | Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. |
• Foot deformity may be present. | • No history of ulceration. | • No history of ulceration. | • History of neuropathic ulceration. |
• No history of ulceration. | No history of Charcot’s joint. | • No history of Charcot’s joint. | • History of Charcot’s joint. |
No foot deformity. | • Foot deformity present. | • Foot deformity present. | |
Category 4A: Neuropathic Ulcer | Category 4B: Acute Charcot’s Joint | Category 5: Infected Diabetic Foot | Category 6: Dysvascular |
Neuropathic Wound | Acute Charcot’s Joint | Infected Diabetic Foot | Foot Ischaemic Limb |
• Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. | • Patient diagnosed with diabetes mellitus. |
• Protective sensation may or may not be intact. | • Protective sensation absent. | • Protective sensation may or may not be intact. | • Protective sensation may or may not be intact. |
• Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. | • Ankle brachial index of >0.8 and toe systolic pressure of >45mmHg. | • Infected wound. | • Ankle brachial index of <0.8 and toe systolic pressure of <45mmHg. |
• Foot deformity normally present. | • Non-infected neuropathic ulceration may be present. | • Charcot’s joint may be present. | • Ulceration may be present. |
• Non-infected neuropathic ulceration. | • Charcot’s joint present. | ||
• No Charcot’s joint present. |