Noticeboard: Vol 11 No 3

Presentations for community nurses
Q Does anyone have any suggestions for topics to cover in a 20-minute presentation on the management of the high-risk foot for community nurses?
Anna Evans, Community Podiatrist, Suffolk PCT 

A I would certainly provide details of the new National Minimum Skills Framework for foot care services – lots of gory photos and case studies always help hammer your messages home! I really cannot stress enough about the importance of pushing for joint assessment and management. Make sure all those attending know which podiatrist works in the health centre they work in and are provided with full contact details. 
Mike Green, Heart of Birmingham teaching PCT

Happy feet
Q A DSN I work with asked me about patients who experience cold feet following commencement of insulin therapy. This has happened with several patients now. Pedal pulses are good and there are no other factors that would lead them to have cold feet. Is anyone able to shed some light on this?
Sandra Jones, Diabetes Clinical Lead Podiatrist, Trafford PCT

A I believe this is possible as in vitro insulin has a vasoconstrictive action. I have been told that, when administered subcutaneously, its main action is in the peripheral circulation rather than the portal circulation. The symptom of this effect would be the cold feet your DSN describes.
Louise Stuart, Lecturer/Practitioner, University of Salford

Knowledge assessment
Q I am looking into assessing the levels of diabetes knowledge in general practice. Has anyone done any work on this already or have any questionnaires or thoughts?
Name and address withheld