What Our Doctors Look For During a Diabetic Foot Exam

Key Takeaways:

Most people with diabetes need a comprehensive foot exam with a podiatrist at least once a year, and individuals with nerve damage, poor circulation, or a past ulcer may need one every 1–3 months. At Austin Foot and Ankle Specialists, we check skin, nerves, circulation, and footwear to catch problems before they cause symptoms. The right schedule depends on your risk level, so your podiatrist sets it with you.

When you have diabetes, taking care of your feet involves more than looking for cuts or wearing comfortable shoes. Even if you haven't noticed pain or other changes, some problems develop without warning and become serious before you realize something is wrong.

Knowing what happens during a diabetic foot exam allows you to feel more confident about protecting your feet.

Dr. Craig Thomajan and Dr. Ricardo Chica are ready to help you take a more proactive approach to diabetic foot health. Their thorough evaluations go beyond identifying existing concerns and providing you with a clearer understanding of your personal risks and what you can do to avoid complications. Here's what to expect during your visit.

What Happens During a Diabetic Foot Exam? 4 Key Points

You want to keep your feet healthy, stay active, and avoid the complications diabetes can cause. But if you've never had a diabetic foot exam, you may feel uncertain about what our podiatrists will do or what the tests might reveal. Fortunately, the exam is simple, generally painless, and designed to give you peace of mind. Here are four important checks we perform and what each tells you about your foot health.

1. Skin and Nail Check

We look over the tops, bottoms, and sides of each foot, plus the spaces between your toes. The goal is to find cuts, blisters, cracks, calluses, color changes, and fungal or ingrown nails. Even a minor break in the skin matters when slow blood flow makes healing harder. This is why our diabetic foot care program starts with a close look at the skin.

2. Nerve Testing

To test protective sensation, Dr. Thomajan or Dr. Chica touches a thin nylon fiber called a monofilament to several spots on each foot and asks whether you feel it. Reflexes and vibration sense may be checked too. Nerve damage known as diabetic neuropathy often develops gradually, so a change can go unnoticed for months. Losing sensation increases the risk of stepping on something without realizing it, so a comprehensive podiatry exam provides essential information. 

3. Circulation and Pulse Checks

We feel the pulses in your feet and ankles and note skin color and temperature. When more detail is needed, a non-invasive vascular test, such as PADnet, shows how well blood is reaching your feet. Poor circulation is the hallmark of peripheral artery disease.

4. Structure and Footwear Review

Bunions, toe deformities, high arches, and stiff joints can all create pressure points. So, our doctors also look at your shoes and socks, since poorly fitting footwear is a common source of sores. Some of our patients are good candidates for custom orthotics to spread pressure more evenly.

How Does Risk Level Change a Diabetic Foot Exam Schedule?

Not everyone with diabetes needs foot exams at the same frequency. Dr. Thomajan and Dr. Chica consider nerve function, circulation, foot deformities, and previous complications to determine how often your feet should be checked. 

The American Diabetes Association's (ADA) most recent guidelines use the same four risk categories established by the International Working Group on the Diabetic Foot:

• Very low risk: Normal protective sensation and no peripheral artery disease. Schedule a diabetic foot exam at least once a year.
• Low risk: Loss of protective sensation or peripheral artery disease. Schedule an exam every 6–12 months.
• Moderate risk: A combination of nerve damage and poor circulation, or either condition along with a foot deformity. Schedule an exam every 3–6 months.
• High risk: Nerve damage or poor circulation combined with a previous foot ulcer, lower-extremity amputation, or end-stage kidney disease. Schedule an exam every 1–3 months.

These are recommended preventive screening intervals, not rigid rules. Your treatment protocol may include more frequent visits based on individual needs. If you’ve lost feeling in your feet or have previously had a foot ulcer or amputation, the ADA also recommends having your feet inspected at every routine medical visit. 

However, don’t wait for a scheduled diabetic foot exam to have a concern evaluated. If you notice a new wound, redness, swelling, or other concerning changes in your foot, contact our office right away. 

What Should You Do Between Visits to Austin Foot and Ankle Specialists?

Your daily habits are just as important as your scheduled diabetic foot exams. Check both feet every day, using a mirror to inspect the soles, and follow our guide to diabetic foot self-exams. 

Also, request a free copy of Dr. Craig Thomajan's book, Diabetes and Your Feet. It covers daily foot care, choosing safe footwear, staying active, and preventing complications. With the right knowledge and a proactive approach to your foot health, you can reduce your risk of serious problems and spend more time enjoying the activities you love.