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Chiropodist

chloe said:
Hi , are diabetics entitled to free foot care from a chiropodist?
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You should be getting your feet checked every twelve months on the NHS and if it shows any issues these will be treated, all NHS treatment is free
 
Free foot care? I was told yes. But not prediabetics.

Seemingly foot related issues are a concern for diabetics so podiatry is deemed significant.

I eventually had to pay to see a podiatrist as they are also called, being categorised as prediabetic.

Funnily enough my neighbour owns a practice. I wouldn’t use him though as would prefer privacy :D

He confirmed this to me while trimming his border with a pair of garden shears.
 
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It is usually the diabetes nurse that does the foot checks on the NHS. Unless you have a problem you are unlikely to see a chiropodist/podiatrist.
 
Bluetit1802 said:
It is usually the diabetes nurse that does the foot checks on the NHS. Unless you have a problem you are unlikely to see a chiropodist/podiatrist.
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I had and still have a problem with my feet. Although they aren’t as bad as they used to be.
 
I think it is only if you have a foot problem that you would be seen by a chiropodist on the NHS. We pay privately for a chiropodist to see my T2 husband and treat his feet to keep them in good condition
 
Pinkorchid said:
I think it is only if you have a foot problem that you would be seen by a chiropodist on the NHS. We pay privately for a chiropodist to see my T2 husband and treat his feet to keep them in good condition
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Indeed they are not manicurists or pedicurists. They refer people to the chiropodist where the foot condition meets the criteria and if diagnosed as diabetic. At least that is what I am being told by the GP , a chiropodist I saw privately and my neighbour (who has his own practice).

(I did consider the advert at the local pet shop for nails clipped for £10)
 
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You also get to see a podiatrist if you have no foot problems but have problems tending to your own feet, my dad is diabetic and has good feet but is blind so it's deemed he needs help caring for them, he's in a home now that has its own podiatrist (you pay for it) still sees the NHS one on a regular basis
 
I'm a podiatrist/chiropodist in Australia. We have a different system here. There are private podiatrist's and there are those employed by government funded hospitals. Usually these are involved with the high risk foot clinics, though some do clinical work with community clients.

We have a system where people can be referred to me by a GP and get a medical refund by the government if you have a chronic illness. So I charge a fee, you get some money back. Sometimes there is a gap where the fee is greater than the refund. They can have up to 5 visits per year.

Generally a diabetic has an annual foot assessment. From this they are classified as low, intermediate and high risk of foot ulceration. Low risk get advice and annual review. Intermediate get more comprehensive advice and 6 monthly review by podiatrist. High risk they visit every 8 -10 weeks for foot care. High risk also get to go to high risk foot clinic if they get an ulcer. Most people just want their nails cut and couldn't careless about a foot check.

There is a difference between podiatry and chiropody. Chiropody was the old english system and dealt with superficial lesions of the foot. Podiatry is the american system and looks at the entire foot and leg from a medical and mechanical point of view. A podiatrist can diagnose disease. Here they changed the name but didnt tell everyone there was also a change in profession. So most people think podiatrists are rebadged chiropodists.

Not all podiatrists are interested in diabetics. You should check before booking to make sure they specialise in diabetes. It makes a big difference to the examination.

My annual foot check includes doppler study of both peripheral arteries and ankle brachial pressure test or toe pressure tests, depending on leg health. Also do monofilament and 128Hz tuning fork neurological tests. A quick look for foot deformity and calluses. If time there may be a quick gait check to identify potential problems. Pressures and 2 types of neuro testing is the minimum for diabetic feet.

Just looking at skin, feeling pulses and wiping cotton balls over the foot isnt good enough any more.
 
Antechinus said:
I'm a podiatrist/chiropodist in Australia. We have a different system here. There are private podiatrist's and there are those employed by government funded hospitals. Usually these are involved with the high risk foot clinics, though some do clinical work with community clients.

We have a system where people can be referred to me by a GP and get a medical refund by the government if you have a chronic illness. So I charge a fee, you get some money back. Sometimes there is a gap where the fee is greater than the refund. They can have up to 5 visits per year.

Generally a diabetic has an annual foot assessment. From this they are classified as low, intermediate and high risk of foot ulceration. Low risk get advice and annual review. Intermediate get more comprehensive advice and 6 monthly review by podiatrist. High risk they visit every 8 -10 weeks for foot care. High risk also get to go to high risk foot clinic if they get an ulcer. Most people just want their nails cut and couldn't careless about a foot check.

There is a difference between podiatry and chiropody. Chiropody was the old english system and dealt with superficial lesions of the foot. Podiatry is the american system and looks at the entire foot and leg from a medical and mechanical point of view. A podiatrist can diagnose disease. Here they changed the name but didnt tell everyone there was also a change in profession. So most people think podiatrists are rebadged chiropodists.

Not all podiatrists are interested in diabetics. You should check before booking to make sure they specialise in diabetes. It makes a big difference to the examination.

My annual foot check includes doppler study of both peripheral arteries and ankle brachial pressure test or toe pressure tests, depending on leg health. Also do monofilament and 128Hz tuning fork neurological tests. A quick look for foot deformity and calluses. If time there may be a quick gait check to identify potential problems. Pressures and 2 types of neuro testing is the minimum for diabetic feet.

Just looking at skin, feeling pulses and wiping cotton balls over the foot isnt good enough any more.
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Here is an NHS document on the topic:

https://www.nhs.uk/live-well/healthy-body/foot-problems-and-the-podiatrist/

I just checked the practice that I used the once only. He is listed as a Chiropodist. I cannot recall all of the fine detail but the main focus of his work was trimming and pedi curing my toe nails. He had all the kit for that and this meant that my fungal infected toenails were nicely clipped and filed down in a way I couldn’t do myself with normal scissors or clippers. I do not recall him doing much else except provide background chat on foot care and diabetes, almost as if he couldn’t provide that element of the service. I left with a great set of toenails, better than when I walked in but not very much else. He charged me £21 for about half an hour. :D
 
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I see a podiatrist every three months, originally as I had corns that needed treating properly. She also carried out a diabetic check on them as a routine thing. I look on it as insurance as the diabetic nurse wears many hats and occasionally seems vague on things... the plus side being that my feet always feel spot on, no hard skin and nails neatly trimmed.

Cost £38 for a half hour appointment.
 
I got referred to a podiatrist but not a chiropodist.
To be honest, I found they did nothing, only scanned over the soles if my feet, never once touched them. So I never went back.
I now see a foot health care lady that comes to my place every six weeks. I pay £26 for this. She sends an hour inspecting all over my feet, cuts my nails and she knows I am t2, she looks for any type of problem.
 
I do all my husbands feet care. He’s given up with the DN.
 
To be a state registered Podiatrist requires a Podiatry BSc(Hons) degree under your belt as it were.

A very intensive degree course one of my tutors has now qualified as a podiatric surgeon very clever guy by the way.

A chiropodist is something entirely different.
 
Listlad said:
Here is an NHS document on the topic:

https://www.nhs.uk/live-well/healthy-body/foot-problems-and-the-podiatrist/

I just checked the practice that I used the once only. He is listed as a Chiropodist. I cannot recall all of the fine detail but the main focus of his work was trimming and pedi curing my toe nails. He had all the kit for that and this meant that my fungal infected toenails were nicely clipped and filed down in a way I couldn’t do myself with normal scissors or clippers. I do not recall him doing much else except provide background chat on foot care and diabetes, almost as if he couldn’t provide that element of the service. I left with a great set of toenails, better than when I walked in but not very much else. He charged me £21 for about half an hour. :D
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The disinction is blurred depending on the age and experience of the practitioner. A chiropist treats the superficial lesions of the foot. Corns, callus, ingrown toenails etc. And do a great job. A podiatrist will examine your foot, tell you why you have corns and callus, sell you some orthotics and send you to the foot technician to have the corns and calls cut off. If they are super keen the technician will be in the same practice.
 
JohnEGreen said:
To be a state registered Podiatrist requires a Podiatry BSc(Hons) degree under your belt as it were.

A very intensive degree course one of my tutors has now qualified as a podiatric surgeon very clever guy by the way.

A chiropodist is something entirely different.
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Yes, It is a degree course here in australia as well.

When I trained over 30 years ago now, it was chiropody & podiatry course combined. We had a lot more hands on training, about 2000 hours of clinical work. Now its mostly lectures and they have to acquire clinical skills later. I'm not sure which is the better way of training professionals, but I know podiatry is much more interesting and varied than chiropody.
 
Listlad said:
@Antechinus
Do we know if rampant fungal infection of the (toe)nails is strongly associated with diabetes?
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I think so. I see a lot of diabetics with fungal issues. I think it has to do with small fibre perpheral neuropathy knocking out the sweat and oil glands in the feet. I believe there is natural antifungals in the oils. Moisturizing creams dont have these chemicals so they may moisten dry skin but not keep fungi at bay. Same with yeast infections.
 
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