27th February 2023

Diabetic Foot Exam: What Happens During the Exam?

Dr. Jill Barat, PharmD
Diabetic Foot Exam: What Happens During the Exam?

For those with diabetes, a foot exam becomes a regular part of their lives, and for good reason.

The American Diabetes Association recommends that every diabetic person gets a thorough foot exam at least once a year.

Diabetes puts you at a higher risk for foot ulcers, and paired with another common side effect of diabetes, neuropathy, it may be more difficult to tell that something painful is happening on the foot before it becomes severe.

In this article, we will cover the 6 main parts of the diabetic foot exam as recommended by the American Diabetes Association to help you know exactly what to expect during this important annual check.


1. History Review

A full history of recent symptoms and related conditions will be reviewed with the diabetic patient.

The patient may be asked about foot or leg pain including burning, tingling, or numbness, as well as pain during rest or a wound that doesn’t seem to be healing.

A review of recent related history including amputations, ulcers, vision problems, and kidney issues will likely be discussed.

The patient will likely be asked about their tobacco use and smoking history, as smoking can have a significant negative effect on your circulation and foot health.


2. Shoe check

During the general physical inspection, the shoes will be looked at to make sure they fit properly and offer adequate protection and support.

If your doctor feels that the shoe does not offer you the best support, they may discuss options or recommendations for better footwear.


3. Visual foot check

During this part of the foot exam, your doctor will go over the entire foot looking for signs of ulceration, redness, toenail issues, or physical deformities.

Your doctor may look for ulcers, athlete's foot, thick calluses, toenail fungus, plantar warts, ingrown nails, hammertoes, or other orthopedic problems.

If you are found to be dealing with any of these during the inspection your doctor will likely offer therapy options or refer you to a specialist.


4. Nerve function tests

Neuropathy, or nerve pain and loss of sensation in the feet are commonly found in those with diabetes.

There are multiple tests that your doctor may use to identify if the nerves in your feet are working properly.

If the nerves are not sending the right signals from your feet to your brain, you may be at higher risk of a foot injury, or not knowing when your feet are hurt.

Your doctor may poke your feet with small nylon fibers to identify if you are able to feel them correctly, or your doctor may use a tuning fork to identify if you can feel vibrations normally.

Sometimes, a pinprick test may be used to identify sensations, or your ankle reflexes may be assessed using a small tendon hammer.


5. Vascular tests

Your doctor may also look into how well your vessels are working to bring blood to and away from your legs and feet.

Your blood pressure may be measured in your ankle using a tool called a doppler to make sure you are getting adequate blood flow for optimal foot and leg health.


6. Assessment

Once all of the tests have been completed, your doctor will likely assign you to a risk classification ranging from 0 to 3.

A classification of 0 means that you are at the lowest risk for ulcers and diabetic foot complications, while 3 means you are in the highest risk group and may need more frequent exams to keep your feet healthy.

At this point, your doctor will likely give you referrals to specialists if one is needed or arrange for prescriptions you may need according to the exam.

Diabetic foot exam: Bottom Line

For those with Diabetes, keeping up with your annual foot exam is an easy but important way to ensure that your feet are as healthy as they can be.

The time your foot exam takes will depend on your provider and the condition of your feet, but it is often a pain-free and relatively quick exam.

While the recommendation from the American Diabetes Association is to have a foot exam once a year, if you notice any new symptoms, wounds, or issues, you should schedule an appointment with your podiatrist as soon as possible.

You may also benefit from including a general foot support supplement like PodiVite into your regimen.* Talk to your doctor to see if a foot care supplement is right for you.*



*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.