Diabetes is a chronic metabolic condition whose impact on the feet is a serious concern. Elevated blood glucose levels over time can damage the nerves (peripheral neuropathy) and restrict blood flow (peripheral artery disease, or PAD). This combination severely compromises the feet’s ability to heal and sense injury. Foot complications are a major cause of hospitalization and the most common reason for non-traumatic lower-limb amputations among individuals with diabetes. Regular, professional foot care with a podiatrist is a preventative measure designed to detect problems early and minimize these risks.
Standard Recommended Frequency
For an individual with diabetes who is considered low-risk, the baseline recommendation is a comprehensive foot examination by a podiatrist at least once a year. A low-risk patient exhibits good circulation, intact nerve sensation, and no history of foot ulcers, amputation, or significant foot deformities. This annual screening establishes a baseline of foot health and confirms the patient remains in a low-risk category. Even without noticeable symptoms, this yearly check is a proactive measure to catch the earliest signs of damage from neuropathy or vascular disease before they escalate into serious complications.
Determining Individualized Risk Levels
The frequency of necessary visits changes significantly once risk factors are identified, moving from an annual check to a schedule tailored to individual need. The podiatrist assigns a risk level based on the initial assessment, which dictates the required follow-up care schedule.
Patients showing signs of peripheral neuropathy (loss of protective sensation) are placed into a higher-risk category. For these individuals, appointments are recommended three to four times per year, or approximately every three to four months. This schedule also applies to those exhibiting signs of vascular compromise, such as poor pulses or skin changes related to peripheral artery disease.
The highest-risk category includes any patient with a history of a foot ulcer, a prior lower-limb amputation, or a significant foot deformity like Charcot foot. These patients require the most vigilant care, often needing to see the podiatrist monthly or at least every six to eight weeks for ongoing preventative management.
What Happens During a Podiatry Appointment
A diabetic foot appointment is a systematic assessment designed to identify signs of nerve damage, poor circulation, and potential injury. The podiatrist performs sensory testing, commonly using a 10-gram monofilament to check for the loss of protective sensation, a key indicator of neuropathy. This test determines if a patient can feel the light pressure necessary to detect a small blister or foreign object. Circulation is assessed by checking the pulses in the foot and ankle and observing the capillary refill time in the toes.
The examination includes a thorough dermatological and structural assessment of the foot. The podiatrist looks for changes in skin texture, color, temperature, and signs of excessive pressure, such as corns, calluses, or fissures. If excessive skin buildup is present, the podiatrist performs therapeutic debridement of calluses and carefully trims toenails, a service often covered by insurance for high-risk diabetics. The appointment concludes with a review of the patient’s current footwear, ensuring shoes are properly fitted and discussing the potential need for custom-molded orthotic devices to redistribute pressure.
Daily At-Home Foot Care
Professional visits supplement, but do not replace, the necessity of diligent daily foot care performed at home.
Daily Inspection and Hygiene
A daily inspection of the feet is paramount, requiring the use of a mirror to check the soles and between the toes for any cuts, blisters, redness, or swelling. Feet should be washed daily in lukewarm water, then patted completely dry, paying particular attention to the spaces between the toes to prevent fungal growth. A moisturizing lotion should be applied to dry skin on the tops and bottoms of the feet, but never between the toes.
Footwear and Toenail Care
Proper footwear is a constant necessity; individuals with diabetes should never walk barefoot, even inside the home. Shoes must be well-fitting and checked before wearing to ensure no foreign objects are inside. When trimming toenails, they should be cut straight across and filed gently to smooth sharp edges, avoiding the cutting of cuticles or digging into the corners. Any sign of a problem, such as persistent redness, sudden swelling, drainage, or an injury that does not begin to heal within 24 hours, requires an immediate call to the podiatrist.