What Is a Diabetic Foot Exam? Everything You Need to Know

If you have diabetes, you’ve probably heard your doctor mention a foot exam at your annual checkup. But what exactly happens during one, and why does it matter so much? Here’s a breakdown of what a diabetic foot exam involves and why it’s one of the most important things you can do to protect your long-term health.

Why Diabetic Foot Exams Are So Important

Diabetes can affect your feet in ways that aren’t always obvious. Over time, high blood sugar can damage nerves and blood vessels, reducing feeling in your feet and slowing down circulation. This means a small cut, blister, or sore can go unnoticed and develop into a serious infection — sometimes leading to amputation. A comprehensive foot exam catches these problems early, before they become dangerous.

What Happens During a Diabetic Foot Exam?

1. Medical History Review

Your provider will start by reviewing your diabetes history. They’ll ask about pain in your calf muscles when walking, any changes in your feet since your last visit, shoe problems, and whether you’ve noticed any blood or discharge on your socks. They’ll also note your most recent hemoglobin A1c result, which reflects how well your blood sugar has been controlled.

2. Skin, Hair, and Nail Inspection

Your provider will closely examine the condition of your skin. They’re looking for signs like thinning or fragile skin, dryness, redness, swelling, calluses, ulcers, and areas of warmth or maceration. Nails are also inspected for thickness, ingrown edges, or fungal infections — all of which can become entry points for infection in people with diabetes.

3. Sensory Testing

One of the most critical parts of the exam is checking whether you can still feel sensation in your feet. Your provider will use a small nylon filament — called a Semmes-Weinstein 5.07 monofilament — and touch it to five specific areas on each foot. If you can’t feel it, that’s a sign of peripheral neuropathy, meaning the nerves in your feet have been damaged. Loss of sensation is a major risk factor for foot ulcers and injuries.

4. Checking Your Pulses

Your provider will feel for two pulses in each foot — the posterior tibial pulse (near your ankle) and the dorsalis pedis pulse (on top of your foot). Weak or absent pulses suggest poor circulation, which is a sign of peripheral vascular disease and means wounds on your feet will heal more slowly.

5. Musculoskeletal Assessment

Your feet are examined for structural deformities such as toe deformities, bunions (hallux valgus), Charcot foot, foot drop, and prominent metatarsal heads. These conditions can create pressure points that lead to sores and ulcers, especially if you’re wearing the wrong footwear.

6. Risk Categorization

Based on everything found during the exam, your provider will place you in one of two categories. Low-risk patients have intact sensation, present pulses, no deformity, no prior ulcers, and no history of amputation. High-risk patients have one or more of the following: loss of protective sensation, absent pulses, foot deformity, a history of foot ulcers, or prior amputation. Knowing your risk level helps determine how closely you need to be monitored.

What Comes After the Exam?

Depending on the findings, your provider may recommend several next steps.

Footwear assessment is a key part of follow-up care. Your provider will note whether you’re wearing appropriate shoes, whether you need inserts, and whether corrective footwear should be prescribed. For many patients, custom diabetic shoes and custom-molded inserts — like the ones we provide at Carolina Healthcare Products — can make a significant difference in preventing pressure sores and ulcers.

Diagnostic studies may be ordered, including vascular lab testing or a hemoglobin A1c check. You may also be referred to specialists such as a podiatrist, diabetes educator, vascular surgeon, or orthotist.

Patient education is always part of the plan. Your provider should offer guidance on preventive foot care, smoking cessation if applicable, and blood sugar management — all of which directly affect your foot health.

How Often Should You Have a Diabetic Foot Exam?

The American Diabetes Association recommends a comprehensive foot exam at least once a year for all people with diabetes. If you’ve been categorized as high risk, your provider may want to see your feet every 1 to 3 months.

How Carolina Healthcare Products Can Help

If your foot exam reveals that you need diabetic shoes, custom inserts, or other supportive footwear, Carolina Healthcare Products is here to help. We specialize in custom-fitted diabetic shoes and therapeutic inserts, and we work with Medicare Part B and most insurance providers to make sure you get the coverage you’re entitled to.

Don’t wait for a problem to develop. Talk to your doctor about scheduling your annual diabetic foot exam — and if they recommend custom footwear, we’re just a call away.

This blog post is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider about your individual care.