Table 6 Summary of IWGDF screening suggestions for Recommendation 1*

Foot screening:

• Aims to identify those at risk of DFU.

• Should specifically include screening for LOPS caused by peripheral neuropathy and for signs or symptoms of PAD.

• Should be performed by an adequately trained health care professional (see glossary for definition) who is also aware of the evidence on screening validity and is competent to undertake further assessment / intervention and/or referral to a suitably trained health care practitioner to ensure individuals receive suitable care.

• The examination should include (but is not limited to):

 - screening for LOPS with a 10-g Semmes Weinstein monofilament [26], or if unavailable, use of the Ipswich Touch Test [38] and screening of vibratory sensation with a tuning fork or biothesiometer/neurothesiometer, if the monofilament testing is negative;

 - screening for PAD as per the IWGDF Guidelines on PAD [39] and/or the Australian DFD Guidelines on PAD [40] by taking a cardiovascular history, palpating for foot pulses, obtaining pedal Doppler arterial waveforms and blood pressure measurements;

 - although evidence for a screening interval is non-existent, we recommend an annual screening for a person with diabetes in whom LOPS or PAD have not yet been identified;

 - further assessment / intervention and/or referral for follow-up if any areas of concern are identified.