Diabetic Foot Exam: MedlinePlus Medical Test (2022)

What is a diabetic foot exam?

People with diabetes are at higher risk for a variety of foot health problems. A diabetic foot exam checks people with diabetes for these problems, which include infection, injury, and bone abnormalities. Nerve damage, known as neuropathy, and poor circulation (blood flow) are the most common causes of diabetic foot problems.

Neuropathy can make your feet feel numb or tingly. It can also cause a loss of feeling in your feet. So if you get a foot injury, like a callus or blister, or even a deep sore known as an ulcer, you may not even know it.

Poor circulation in the foot can make it harder for you to fight foot infections and heal from injuries. If you have diabetes and get a foot ulcer or other injury, your body may not be able to heal it fast enough. This can lead to an infection, which can quickly become serious. If a foot infection is not treated right away, it can become so dangerous that your foot may need to be amputated to save your life.

Fortunately, regular diabetic foot exams, as well as home care, can help prevent serious foot health problems.

Other names: comprehensive foot exam

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What is it used for?

A diabetic foot exam is used to check for foot health problems in people with diabetes. When ulcers or other foot problems are found and treated early, it can prevent serious complications.

Why do I need a diabetic foot exam?

People with diabetes should get a diabetic foot exam at least once a year. You may need an exam more often if your feet have any of the following symptoms:

  • Tingling
  • Numbness
  • Pain
  • Burning sensation
  • Swelling
  • Pain and difficulty when walking

You should call your health care provider right away if you have any of the following symptoms, which are signs of a serious infection:

  • A blister, cut, or other foot injury that doesn't start to heal after a few days
  • A foot injury that feels warm when you touch it
  • Redness around a foot injury
  • A callus with dried blood inside it
  • An injury that is black and smelly. This is a sign of gangrene, the death of body tissue. If not treated promptly, gangrene can lead to amputation of the foot, or even death.

What happens during a diabetic foot exam?

A diabetic foot exam may be done by your primary care provider and/or a foot doctor, known as a podiatrist. A foot doctor specializes in keeping feet healthy and treating diseases of the feet. The exam usually includes the following:

General assessment. Your provider will:

  • Ask questions about your health history and any previous problems you've had with your feet.
  • Check your shoes for proper fit and ask questions about your other footwear. Shoes that don't fit well or are otherwise uncomfortable can lead to blisters, calluses, and ulcers.

Dermatological assessment. Your provider will:

  • Look for various skin problems, including dryness, cracking, calluses, blisters, and ulcers.
  • Check the toenails for cracks or fungal infection.
  • Check between the toes for signs of a fungal infection.

Neurologic assessments. These are a series of tests that include:

  • Monofilament test. Your provider will brush a soft nylon fiber called a monofilament over your foot and toes to test your foot's sensitivity to touch.
  • Tuning fork and visual perception tests (VPT). Your provider will place a tuning fork or other device against your foot and toes to see if you can feel the vibration it produces.
  • Pinprick test. Your provider will gently poke the bottom of your foot with a small pin to see if you can feel it.
  • Ankle reflexes. Your provider will check your ankle reflexes by tapping on your foot with a small mallet. This is similar to a test you may get at an annual physical, in which your provider taps just below your knee to check your reflexes.

Musculoskeletal assessment. Your provider will:

  • Look for abnormalities in the shape and structure of your foot.

Vascular assessment. If you have symptoms of poor circulation, your provider may:

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  • Use a type of imaging technology called Doppler ultrasound to see how well blood is flowing in your foot.
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Will I need to do anything to prepare for the test?

You don't need any special preparations for a diabetic foot exam.

Are there any risks to the test?

There are no known risks to having a diabetic foot exam.

What do the results mean?

If a problem is found, your foot doctor or other provider will likely recommend more frequent testing. Other treatments may include:

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  • Antibiotics to treat foot infections
  • Surgery to help with bone deformities

There is no treatment for nerve damage to the foot, but there are treatments that can relieve pain and improve function. These include:

  • Medicine
  • Skin creams
  • Physical therapy to help with balance and strength

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a diabetic foot exam?

Foot problems are a serious risk to people with diabetes. But you can help keep your feet healthy if you:

  • Take care of your diabetes Work with your health care provider to keep your blood sugar at a healthy level.
  • Get regular diabetic foot exams. You should get your feet checked at least once a year, and more often if you or your provider finds a problem.
  • Check your feet every day. This can help you find and address problems early before they get worse. Look for sores, ulcers, toenail cracks, and other changes in your feet.
  • Wash your feet every day. Use warm water and mild soap. Dry thoroughly.
  • Wear shoes and socks at all times. Make sure your shoes are comfortable and fit well.
  • Trim your toenails regularly. Cut straight across the nail and gently smooth edges with a nail file.
  • Protect your feet from excess heat and cold. Wear shoes on hot surfaces. Don't use heating pads or hot bottles on your feet. Before putting your feet in hot water, test the temperature with your hands. Because of reduced sensation, you can burn your feet without knowing it. To protect your feet from cold, wear socks in bed, don't go barefoot. In the winter, make sure you wear lined, waterproof boots.
  • Keep blood flowing to your feet. Put your feet up when sitting. Wiggle your toes for a few minutes two or three times a day. Stay active, but choose activities that are easy on the feet, such swimming or biking. Talk to your provider before starting an exercise program.
  • Don't smoke. Smoking reduces blood flow to the feet and can make wounds heal slowly. Many diabetics who smoke need amputations.

References

  1. American Diabetes Association [Internet]. Arlington (VA): American Diabetes Association; c1995–2019. Foot Care; [updated 2014 Oct 10; cited 2019 Mar 12]; [about 3 screens]. Available from: http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html
  2. American Diabetes Association [Internet]. Arlington (VA): American Diabetes Association; c1995–2019. Foot Complications; [updated 2018 Nov 19; cited 2019 Mar 12]; [about 3 screens]. Available from: http://www.diabetes.org/living-with-diabetes/complications/foot-complications
  3. Beaver Valley Foot Clinic [Internet]. Podiatrist Near Me Pittsburgh Foot Doctor Pittsburgh PA; c2019. Glossary: Beaver Valley Foot Clinic; [cited 2019 Mar 12]; [about 3 screens]. Available from: https://bvfootclinic.com/glossary
  4. Boulton, AJM, Armstrong DG, Albert SF, Frykberg, RG, Hellman R, Kirkman MS, Lavery LA, LeMaster, JW, Mills JL, Mueller MJ, Sheehan P, Wukich DK. Comprehensive Foot Examination and Risk Assessment. Diabetes Care [Internet]. 2008 Aug [cited 2019 Mar 12]; 31(8):1679–1685. Available from: http://care.diabetesjournals.org/content/31/8/1679
  5. Country Foot Care [Internet]. Country Foot Care; 2019. Glossary of Podiatry Terms; [cited 2019 Mar 12]; [about 3 screens]. Available from: https://countryfootcare.com/library/general/glossary-of-podiatry-terms
  6. FDA: US Food and Drug Administration [Internet]. Silver Spring (MD): U.S. Department of Health and Human Services; FDA permits marketing of device to treat diabetic foot ulcers; 2017 Dec 28 [cited 2020 Jul 24]; [about 4 screens]. Available from: https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-device-treat-diabetic-foot-ulcers
  7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Diabetic Neuropathy: Diagnosis and treatment; 2018 Sep 7 [cited 2019 Mar 12]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/diagnosis-treatment/drc-20371587
  8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Diabetic Neuropathy: Symptoms and causes; 2018 Sep 7 [cited 2019 Mar 12]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580
  9. Mishra SC, Chhatbar KC, Kashikar A, Mehndiratta A. Diabetic foot. BMJ [Internet]. 2017 Nov 16 [cited 2019 Mar 12]; 359:j5064. Available from: https://www.bmj.com/content/359/bmj.j5064
  10. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Diabetes and Foot Problems; 2017 Jan [cited 2019 Mar 12]; [about 5 screens]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
  11. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Peripheral Neuropathy; 2018 Feb [cited 2019 Mar 12]; [about 6 screens]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/peripheral-neuropathy
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Special Foot Care for Diabetes; [cited 2019 Mar 12]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&contentid=4029
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Treating Diabetic Foot Problems: Topic Overview; [updated 2017 Dec 7; cited 2019 Mar 12]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/special/treating-diabetic-foot-problems/uq2713.html

FAQs

Diabetic Foot Exam: MedlinePlus Medical Test? ›

A diabetic foot exam checks people with diabetes for these problems, which include infection, injury, and bone abnormalities. Nerve damage, known as neuropathy, and poor circulation (blood flow) are the most common causes of diabetic foot problems.

How do you check for diabetic foot? ›

Get to the bottom of any foot problems by using a mirror or asking for help. Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Use a mirror if you can't see the bottom of your feet, or ask a family member to help.

When should a diabetic foot exam be performed? ›

In people with type 1 diabetes, annual foot exams should begin five years after diagnosis. In people with type 2 diabetes, annual foot exams should begin at the time of diagnosis. During a foot exam, your health care provider will check for poor circulation, nerve damage, skin changes, and deformities.

What is a foot screen test? ›

McKesson monofilament foot screen test is a foot screening device used to assess loss of protective sensation. It helps identify patients at risk of developing diabetic foot ulcers. The monofilament foot screen test screening has a 10 gram filament.

How is diabetic foot ulcer diagnosed? ›

Your doctor inspects the foot, toes, and toenails for blisters, cuts, scratches, or ingrown toenails that may lead to additional ulcers. He or she also evaluates the rate of blood flow in the foot by feeling the pulse.

What happens at a diabetic foot exam? ›

During a diabetic foot exam, your doctor may ask questions about your health history and any previous problems you've had with your feet. Your doctor should also check your shoes for proper fit and ask questions about all of your footwear. Shoes that don't fit well can lead to blisters, calluses, and ulcers.

Can a nurse do a diabetic foot exam? ›

Several studies suggest that patient education about foot care is effective in prevention of diabetic foot ulcers [53-55]. Nurses can teach patients how to perform physical examination and take care of their feet on a daily basis [56].

Why do doctors check your feet when you have diabetes? ›

Diabetes can reduce blood circulation and damage the nerves to the feet. Ask your doctor to examine your feet regularly for any evidence of nerve damage or poor circulation. Foot problems can be avoided if you take care of your feet and act quickly if you have a problem.

How do you test for foot neuropathy? ›

Sensory examination

The most important exam for testing for neuropathy in the foot is the neurological physical examination in the office. This exam consists of deep tendon reflex, proprioceptive exam, sharp and dull touch, warm and cold temperature testing and vibratory sensation.

Why do doctors check the bottom of your feet? ›

Get a leg up.

We check your legs and feet to look for swelling. People with heart or liver disease may have fluid back-up in their legs, but it can also be a sign of infection or blood clots. We also check the pulses in your feet and look for any skin problems.

How do you do a diabetic foot monofilament test? ›

The monofilament must be placed at 90 degrees to the skin surface. It is applied, held and released in a controlled manner. It should be applied, held and released over 1–2 seconds for each test. When applied and held the monofilament should buckle at about 1 cm from the horizontal.

What is diabetic foot ulcer? ›

A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes, and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.

What is Biothesiometry test? ›

Biothesiometry, a rapid, portable, and sensitive method of assessing VPTs, has been used on adolescents and adults to identify subclinical neuropathy and to monitor the progress of the disease. In adulthood, VPTs have been shown to be affected by increasing age and to be depen- dent on height (10,11).

What are 3 things you should never do to the feet of someone with diabetes? ›

Avoid soaking your feet, as this can lead to dry skin. Dry your feet gently, especially between the toes. Moisturize your feet and ankles with lotion or petroleum jelly. Do not put oils or creams between your toes — the extra moisture can lead to infection.

What is the monofilament test? ›

Overview. A monofilament test is done to test for nerve damage (peripheral neuropathy), which may be caused by conditions such as diabetes. The monofilament is a small strand of nylon attached to a plastic base. The provider uses this monofilament to check for loss of feeling on your foot.

How do you test for foot neuropathy? ›

Sensory examination

The most important exam for testing for neuropathy in the foot is the neurological physical examination in the office. This exam consists of deep tendon reflex, proprioceptive exam, sharp and dull touch, warm and cold temperature testing and vibratory sensation.

What are the 3 most common symptoms of undiagnosed diabetes? ›

The three most common symptoms of undiagnosed diabetes include increased thirst, increased urination, and increased hunger. Diabetes is a metabolic disorder that happens when blood sugar (glucose) is too high (hyperglycemia).

What is the treatment for diabetic foot? ›

Cleaning the wound. Draining any fluid or pus from the ulcer. Removing or cutting away dead or infected tissue (called debridement). Applying special bandages and ointments to absorb extra fluid, protect the wound and help it heal.

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