Diabetic Foot Care: Annual Exam, Prevention & Warning Signs | Balance Foot & Ankle

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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Diabetes is the leading cause of non-traumatic lower limb amputation in the United States — a statistic that is almost entirely preventable with proper podiatric care. The combination of peripheral neuropathy (nerve damage), peripheral vascular disease (reduced circulation), and impaired wound healing creates a dangerous triad that can turn a minor foot problem into a limb-threatening complication. Consistent preventive foot care and annual podiatric examination are among the most cost-effective health interventions available to people with diabetes.

How Diabetes Affects Your Feet

Peripheral Neuropathy

High blood glucose over time damages peripheral nerves, producing diabetic peripheral neuropathy — a loss of protective sensation in the feet and lower legs. Patients lose the ability to feel pain, temperature, and pressure. This means a blister, cut, or foreign body in the shoe goes unfelt until it has created an open wound. Approximately 50% of people with diabetes will develop some degree of peripheral neuropathy.

Peripheral Vascular Disease

Diabetes accelerates atherosclerosis in the leg arteries, reducing blood flow to the feet. Poor circulation impairs wound healing, makes infections more severe, and reduces the effectiveness of systemic antibiotics in reaching the tissues. Reduced circulation combined with neuropathy dramatically increases ulcer and amputation risk.

Immune Dysfunction

Elevated blood glucose impairs white blood cell function, reducing the body’s ability to fight infection. A diabetic foot infection that might be a minor cellulitis in a non-diabetic patient can rapidly progress to osteomyelitis (bone infection) or necrotizing fasciitis in a patient with poorly controlled diabetes.

The Annual Diabetic Foot Exam: What to Expect

The American Diabetes Association recommends an annual comprehensive foot examination for all patients with diabetes. At Balance Foot & Ankle, Dr. Biernacki performs a structured examination that includes:

• Monofilament testing — a 10-gram Semmes-Weinstein monofilament applied to key areas of the plantar foot assesses protective sensation
• Vibration sense testing — a 128 Hz tuning fork at the dorsum of the great toe assesses large-fiber neuropathy
• Vascular assessment — palpation of the dorsalis pedis and posterior tibial pulses; ABI (ankle-brachial index) when indicated to assess arterial insufficiency
• Skin and nail inspection — evaluation for calluses, corns, fissures, tinea pedis, onychomycosis, and pressure points that can evolve into ulcerations
• Musculoskeletal assessment — evaluation of foot deformities (Charcot foot, hammertoes, bunions) that create pressure points prone to ulceration
• Footwear evaluation — assessment of current shoes for proper fit, depth, and pressure distribution

Warning Signs That Require Immediate Evaluation

Every person with diabetes should know these red-flag warning signs that require same-day or emergency podiatric evaluation:

• Any open wound, ulcer, or blister — regardless of how small it appears
• Redness, warmth, or swelling that does not resolve within 24–48 hours
• Drainage or odor from any area of the foot
• A dark or black discoloration of any toe or area of skin
• New areas of numbness, tingling, or burning in the feet
• A Charcot foot presentation — acute painless swelling, warmth, and redness of one foot without injury (a diabetic emergency)

Diabetic Foot Care: Daily Prevention Habits

Between podiatric appointments, daily preventive care dramatically reduces complication risk:

• Daily inspection — examine the entire foot including between all toes every day; use a mirror or smartphone camera for the sole if bending is difficult
• Moisturizing — apply urea-based or petroleum moisturizer to the heels and soles daily (not between toes) to prevent fissures
• Nail care — trim nails straight across, never rounded at the corners; visit Dr. Biernacki for professional nail care if vision or dexterity is limited
• Proper footwear — wear well-fitted, closed-toe shoes with adequate depth at all times; never walk barefoot, even indoors
• Diabetic socks — seamless, non-constricting socks reduce pressure points and improve circulation
• Blood glucose control — maintaining HbA1c below 7% reduces neuropathy progression and wound healing impairment

Medicare Coverage for Diabetic Foot Care

Medicare covers annual diabetic foot examinations for patients with diabetes and peripheral neuropathy. Medicare also covers therapeutic diabetic shoes and custom insoles for qualifying patients. Dr. Biernacki accepts Medicare and most major insurance plans — call (810) 206-1402 to schedule your annual diabetic foot examination.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

More Podiatrist-Recommended Diabetic Essentials

Diabetic-Approved Walking Shoe

Orthofeet Sprint — seamless, extra-depth, designed for neuropathic feet.

Seamless Diabetic Sock

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OS1st FS4 — non-binding, moisture-wicking, protects fragile diabetic skin.

Recovery Slide for Indoor Wear

HOKA Ora 3 — protects diabetic feet from barefoot injury at home.

As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.

When to See a Podiatrist

One unnoticed blister on a neuropathic foot can become a limb-threatening ulcer in under 14 days. Medicare covers diabetic shoes (A5500) and comprehensive foot exams annually for most diabetic patients with neuropathy or circulation concerns. Balance Foot & Ankle runs a dedicated diabetic limb-preservation program — vascular screening, offloading, ulcer care, and shoe fitting — all in one visit. Schedule your annual diabetic foot exam today.

Call Balance Foot & Ankle: (810) 206-1402  ·  Book online  ·  Offices in Howell & Bloomfield Hills

Dr. Tom’s Recommended Products for diabetic foot care

Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.

Drew Moonwalker Diabetic Shoe Dr. Tom’s Pick

Best for: Medicare-covered diabetic footwear

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Diabetic Compression Socks Dr. Tom’s Pick

Best for: Daily protection + circulation

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Hibiclens Antiseptic Dr. Tom’s Pick

Best for: Wound prep + paronychia care

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Magnifying Mirror with Light Dr. Tom’s Pick

Best for: Daily foot inspection

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.