E. NERVE & FOOT HEALTH
10. Comprehensive Foot Examination
What it measures: A structured check of both feet, including a visual inspection for cuts, calluses, ulcers, or deformities; a check of pulses in the feet (circulation); and tests of protective sensation, typically using a 10g monofilament (a thin plastic thread pressed against the skin at several points) and sometimes a tuning fork to check vibration sensation.
Why it's needed: Diabetes can damage both the nerves (peripheral neuropathy, causing loss of protective sensation, so injuries go unnoticed) and blood circulation to the feet, which together are the main reasons diabetic foot ulcers and, in severe untreated cases, amputations occur. Most of these outcomes are preventable with regular screening, proper footwear, and prompt treatment of minor injuries.
How often: A comprehensive exam (with monofilament and pulse check) at least once a year for everyone with diabetes; a quick visual self-check at home is recommended daily, and a visual check by a healthcare provider at every clinic visit is reasonable, especially for anyone who already has reduced sensation or a history of foot ulcers.