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Patients often ask me, what's involved in an annual comprehensive diabetic foot exam? Actually, it's a very simple, comfortable and painless exam to have done.
We start by looking at your medical history: what other problems do you have besides diabetes? We look at the medications you're taking, because some medications can mimic certain symptoms of diabetes. We want to know what your allergies are. Beyond that, it becomes more of a basic exam …
For example, we look at your circulation. We feel the pulses in your feet, to see how good they are. If we have any problem feeling the pulses, we have specialized equipment that can, in much more detail, determine the circulation down to your feet.
We want to look at the skin and the nails, to see if there are any problems indicating either a local issue going on in your feet, or a more systemic problem that's going on with your diabetes. We want to look even at just the nails — how thick are they? Sometimes patients will get thick nails, and in a diabetic patient, that can cause a sore to form under the nail. Are the nails ingrowing? Maybe there's a little infection from the ingrowing nail. Maybe that's not a big problem in someone without diabetes, but in diabetic patients, a small infection can become a big problem very quickly.
We want to see how good the feeling is in your feet. We look at things like the ankle reflexes. You've probably had a reflex test before, perhaps during a physical at your primary care doctor's office. We want to look to see if you have that reflex. Because, when you lose that reflex, it's one of the earliest indicators of nerve damage.
We check your temperature sensation. Can you feel cold, from the tops and bottoms of your feet? When you lose temperature sensation, that's also an indicator of some damage to the nerves.
We use a tool called a monofilament to test the sensation in your feet. It's very soft, and it doesn't hurt. But it's set at a certain pressure, and if you can feel it, then you have enough sensation to know if you're causing damage to your feet. We can check by touching the monofilament to different areas of your feet to see if you can or can't feel it.
One of the earliest indicators of nerve damage is vibratory sensation. When you have your physical with your primary care physician, they might take a tuning fork and touch it to your foot. Well, that's good, but it's not really that accurate. We use something called a biothesiometer, which we can adjust to measure how much vibration you feel, so we can actually quantify the level of nerve function that you have. Again, it's completely painless. We touch the device to your toe, and as we adjust it, you just tell us when you can or cannot feel it anymore.
We look at deformities in your foot. Do you have any bunions, or hammer toes (toes that bend up)? These are areas that can rub in your shoe and become points of infection. These are also places where ulcers might form. And ulcers are serious in diabetics, because 15 percent of diabetic patients who get an ulcer will go on to have an amputation of their leg — which is what we're ultimately trying to prevent.
As you can see, a comprehensive diabetic foot exam a very simple examination, completely painless, and it takes about 20 - 30 minutes. If you have diabetes, making sure you get this exam every year is one of the most important things you can do to manage your diabetes and prevent amputations.
For more information or to schedule your diabetic foot exam, give us a call at 804-320-FOOT (804-320-3668), or check out the links below. Please help us spread the word about this simple but lifesaving exam — If you know someone who has diabetes, please share this post with them using the social sharing icons at the bottom of this page.
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FAQs
Your provider will check: The skin of your feet to look for dryness, cracking, calluses, blisters, ulcers, and other damage or abnormal areas. Your toenails for cracks and fungal infection. The temperature of your feet to see if they are the same.
What happens during a diabetic foot exam? ›
You'll need to take off any dressings and footwear, including socks and tights. Your feet will be examined. Numbness or changes in sensation (also known as neuropathy) will be tested with a special piece of equipment. They'll also check your shoes to make sure they're not causing any problems.
How long does a diabetic foot check take? ›
As you can see, a comprehensive diabetic foot exam a very simple examination, completely painless, and it takes about 20 - 30 minutes. If you have diabetes, making sure you get this exam every year is one of the most important things you can do to manage your diabetes and prevent amputations.
What is the protocol for diabetic foot exam? ›
The foot examination should include inspection, assessment of foot pulses, and testing for loss of protective sensation (10-g monofilament plus testing any one of: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold). American Diabetes Association (ADA).
What happens in diabetic foot clinic? ›
Each patient will have their medical history, and foot vascular and neurological status checked. Both feet will be checked at each appointment and a plan will be made between the patient and the podiatrist dependent on the consultation's findings.
What part of the foot hurts with diabetes? ›
When you have diabetes, high glucose levels in the blood can damage nerves and blood vessels. Because the nerves and blood vessels supplying the feet are so long and delicate, the feet — and especially the toes — often get affected first.
What does a podiatrist do for diabetic feet? ›
In addition, podiatrists may assist diabetics manage their disease by giving knowledge and support. This may include educating patients how to properly care for their feet and prevent infections, as well as advising them on how to regulate their blood sugar levels and limit the risk of complications.
What do diabetic feet look like? ›
changes in the colour and shape of your feet. cold or hot feet. blisters and cuts that you can see but don't feel. foul smell coming from an open wound.
What is the first rule of diabetic foot care? ›
1. Inspect your feet daily. Check your feet for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet.
Can a nurse perform a diabetic foot exam? ›
In true collaborative form, RNs perform regular foot assessments and examine pa- tients for signs of neuropathy, poor circulation, foot ul- cers, or other abnormalities, which allows for early identification, prompt intervention, and prevention of worsening conditions.
Your provider will check: The skin of your feet to look for dryness, cracking, calluses, blisters, ulcers, and other damage or abnormal areas. Your toenails for cracks and fungal infection. The temperature of your feet to see if they are the same.
Can you recover from diabetic foot? ›
Most people fully recover from a diabetic foot ulcer after the wound is cleaned and disinfected. To prevent new ulcers from forming, NYU Langone doctors recommend long- term use of custom orthotic shoe inserts to better align the bones of the foot and more evenly distribute the weight of the body during movement.
How do doctors treat diabetic foot? ›
Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.
How is a diabetic foot diagnostic done? ›
Approach Considerations. Patient workup for diabetic ulcers includes blood tests, radiography, ankle-brachial index and toe pressure, pulse-volume recording, ultrasonography, computed tomography (CT) scanning or magnetic resonance imaging (MRI), bone scans, and angiography.
What does diabetic foot care include? ›
Daily foot care
Suggestions to help prevent foot problems in people with diabetes who suffer from neuropathy or vascular disease include: Check your feet daily for signs of swelling, redness or heat – these may be signs of infection. Wash your feet daily and dry well between the toes.
How does a podiatrist check your feet? ›
Physical Examination
During this examination, the podiatrist will look at the overall structure of your feet, checking for abnormalities like bunions, hammertoes, or arch problems. They may ask you to walk or perform specific movements to evaluate your gait and foot mechanics.
What happens in a diabetes assessment? ›
An HbA1c test is the main blood test used to diagnose diabetes. It tests your average blood sugar levels for the last two to three months. You don't need to prepare for a HbA1c . It's a quick and simple test where a small amount of blood is taken from a vein in your arm.
