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

Quick answer: Diabetic Foot Care Annual Exam Prevention Guide is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

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

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.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your diabetic foot, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

More questions patients ask

How often should diabetics check their feet?

Diabetic patients should perform daily self-examinations of both feet, checking for cuts, blisters, redness, swelling, calluses, and temperature changes. Professional diabetic foot exams should occur at least annually, or every 3-6 months for patients with neuropathy, peripheral artery disease, or history of foot ulcers. Dr. Biernacki provides comprehensive diabetic foot care programs.

Why do diabetics have foot problems?

Diabetes causes peripheral neuropathy (nerve damage reducing sensation), peripheral artery disease (reduced blood flow), and impaired immune function. This combination means injuries go unnoticed, heal slowly, and are prone to infection. Approximately 15% of diabetics will develop a foot ulcer, and diabetic foot complications are the leading cause of non-traumatic amputation. Prevention through regular podiatric care is essential.

What are the signs of diabetic neuropathy in feet?

Early signs include tingling, burning, or numbness starting in the toes and progressing upward. Other symptoms include sensitivity to touch, muscle weakness, balance problems, and loss of reflexes. If you experience any of these symptoms, schedule an evaluation with Dr. Biernacki at 810-206-1402 for nerve conduction testing and a comprehensive neuropathy management plan.

Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.