Individuals managing diabetes face a heightened risk of developing foot complications, ranging from minor sores to severe infections and, in the worst cases, amputation. Elevated blood sugar levels damage the body’s nerves (peripheral neuropathy) and restrict blood flow (peripheral artery disease, or PAD). These changes mean a small cut or blister can quickly progress into a non-healing ulcer because the patient may not feel the injury, and reduced circulation hinders the healing process. A podiatrist specializes in the prevention, diagnosis, and treatment of foot conditions. Regular, specialized foot examinations are designed to identify subtle changes in sensation, circulation, and foot structure before they lead to serious problems.
The Baseline Recommendation for Low-Risk Patients
For the majority of individuals with diabetes, an annual comprehensive foot examination by a podiatrist is the standard recommendation. This frequency applies to those considered low-risk, meaning they exhibit no signs of nerve damage or poor circulation in their lower extremities. A low-risk patient has intact protective sensation, easily palpable pedal pulses, and no history of foot ulcers or significant foot deformities. This yearly visit is necessary even if the patient feels their feet are entirely healthy.
The purpose of this yearly assessment is to establish a baseline and screen for the earliest signs of complications that may be developing silently. Neuropathy and circulation issues can progress without noticeable symptoms, which is why a professional evaluation is important. If the podiatrist detects any change from the established low-risk status, the patient’s visit frequency will be immediately adjusted for closer monitoring.
Risk Factors That Dictate Increased Visit Frequency
The required frequency of podiatry visits significantly increases for patients who have developed specific risk factors, moving from annual to semi-annual or quarterly care.
Loss of protective sensation (peripheral neuropathy) is a primary indicator for more frequent visits, often necessitating an examination every three to six months. When the nerves in the feet are damaged, the patient cannot feel the pressure or injury that causes a wound, which significantly increases the risk of ulceration.
Peripheral artery disease (PAD), marked by diminished or absent pulses in the foot, also places a patient into a higher-risk category requiring check-ups every three to six months. Poor blood flow prevents the body from delivering the necessary immune cells and nutrients to heal wounds.
Furthermore, any existing foot deformities, such as bunions or hammertoes, or a history of a previous foot ulcer or amputation, mandates the most frequent surveillance. Patients with a history of a foot ulcer or amputation are at the highest risk for recurrence and may need to see their podiatrist every one to three months, or even at every scheduled healthcare visit.
What to Expect During a Diabetic Foot Exam
Regardless of the frequency, a diabetic foot exam follows a standardized procedure to thoroughly assess the patient’s risk profile.
Nerve Function Assessment
The evaluation of nerve function is typically performed using the 10-gram monofilament test. The podiatrist applies a thin nylon filament to specific points on the foot to check the patient’s ability to sense pressure. This test determines if the patient has lost the protective sensation necessary to detect injuries. Sensation testing may also include a vibration perception test using a tuning fork placed on the bony prominences of the foot.
Vascular Assessment
The vascular assessment involves palpating the dorsalis pedis and posterior tibial pulses on the top and inside of the foot to evaluate blood flow. Skin temperature may also be checked. If pulses are weak or absent, further testing like an Ankle-Brachial Index (ABI) may be ordered to measure circulatory efficiency.
Visual Inspection and Guidance
A visual inspection is performed to check the skin for signs of dryness, cracks, calluses, or early-stage ulcers, including between the toes. The appointment concludes with guidance on proper daily foot hygiene and recommendations for supportive, well-fitting footwear to minimize pressure points and prevent future injuries.