Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
For Farmington Hills diabetic patients, the most predictive test for amputation risk isn’t blood sugar — it’s a 60-second monofilament sensation test on 10 specific points of the foot. Most patients who later develop ulcers had already lost protective sensation years earlier without knowing it. Call (810) 206-1402 — comprehensive diabetic foot exams available in Farmington Hills.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Diabetic Foot Exam Near Farmington Hills, MI
Comprehensive diabetic foot exams near Farmington Hills, MI are available at Balance Foot & Ankle in Bloomfield Hills. Dr. Biernacki DPM performs the ADA-recommended annual evaluation — 10-gram monofilament neuropathy screening, ankle-brachial index vascular assessment, ulcer risk stratification, callus debridement, and nail/skin care — to prevent the 85% of diabetic amputations that are avoidable. Call (810) 206-1402.
Why the Annual Diabetic Foot Exam Prevents Amputations
85% of all lower extremity amputations in diabetic patients are preceded by a foot ulcer — and the vast majority are preventable with proper monitoring and timely intervention. The problem is neuropathy: once diabetic peripheral neuropathy develops, pain disappears as a warning signal. A blister or infected nail that would immediately demand attention in a non-diabetic patient can go unnoticed for days in a neuropathic patient — progressing silently from wound to deep infection to osteomyelitis. The ADA recommends comprehensive podiatric foot examination annually for all diabetic patients with neuropathy or vascular disease — and more frequently for high-risk patients. In our Farmington Hills-area diabetic population, the consistent finding is that patients who keep annual podiatric appointments have dramatically fewer serious foot complications. The annual exam substitutes the inspection and early warning that neuropathy has eliminated. Callus — the #1 precursor to diabetic plantar ulcers — is identified and debrided before it becomes a pressure ulcer.
Key Takeaway: 85% of diabetic amputations are preventable. Annual exam catches neuropathy progression, vascular compromise, and callus (pre-ulcer) before they become limb-threatening. Warm swollen diabetic foot = Charcot until proven otherwise — same-day evaluation. Never self-cut diabetic toenails with scissors. Daily home foot inspection between annual visits is non-negotiable.
What the Comprehensive Diabetic Foot Exam Includes
Neuropathy screening: 10-gram Semmes-Weinstein monofilament at 10 plantar sites — loss at ≥1 site indicates significant neuropathy. Vibration perception (128 Hz tuning fork at 1st MTP). Vascular assessment: Ankle-brachial index — ABI <0.9 = PAD, high healing risk. Capillary refill, skin temperature symmetry, hair loss assessment. Dermatologic exam: Pre-ulcer callus debridement at every visit (callus over pressure points is the #1 precursor to plantar ulcer), interdigital maceration check, skin integrity survey. Nail examination: Mycotic nails (oral terbinafine or professional management), ingrown nails (professional treatment only — never home cutting). Structural assessment: Hammertoes, bunions, Charcot deformity — high-pressure areas needing protective footwear or custom orthotics. Risk stratification: Low risk (sensation intact, no deformity) = annual; Moderate = semi-annual; High risk (neuropathy + deformity or prior ulcer) = every 1–3 months.
⚠️ Diabetic Patients — Immediate Evaluation Needed For:
- Any open wound, blister, or skin break — even painless and small
- Warm, red, swollen foot — Charcot neuroarthropathy or infection, same-day evaluation
- Red streaking from a wound, fever, or chills — spreading infection, ER urgency
- Toenail that has cut into the skin — infection risk, professional treatment only
- Any change in numbness or tingling pattern — worsening neuropathy needs reassessment
Diabetic Foot Protection Products
Between annual diabetic foot exams, these products form the foundation of daily diabetic foot self-care:
TXG Seamless Diabetic Socks — Daily Foot Protection
Seamless diabetic socks eliminate the #1 cause of friction-related foot wounds in diabetic patients: the traditional toe seam. These are knit seamlessly, moisture-wicking, and non-binding at the top — protecting circulation while keeping the foot dry. Wearing these daily is one of the simplest, highest-impact diabetic foot care habits. We recommend them to every diabetic patient at their annual exam.
New Balance 928v3 — APMA-Approved Diabetic Walking Shoe
Carries the American Podiatric Medical Association Seal of Acceptance. Features a fully seamless interior, wide/extra-wide last (up to 4E), removable insole for custom orthotics, and a rollbar that compensates for the proprioception loss that accompanies neuropathy. This is the shoe I recommend most to diabetic patients who ask what shoe is safest for their feet. Available through Medicare Part B diabetic shoe benefit.
Getting to Our Office From Farmington Hills
Our Bloomfield Hills office at 43494 Woodward Ave #208 is about 15–20 minutes from Farmington Hills via I-696 E to Woodward Ave. We accept most major insurance. Call (810) 206-1402 or book online.
Diabetic Patient? Schedule Your Annual Foot Exam
Balance Foot & Ankle · Serving Farmington Hills & Michigan
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
A diabetic foot exam near Farmington Hills is a comprehensive evaluation designed to catch problems before they become serious. Our podiatrist serving Farmington Hills performs a thorough assessment of skin integrity, nail health, circulation, and nerve function. The neurological check tests for peripheral neuropathy using a monofilament wire and tuning fork. Vascular assessment measures pulses and blood flow to identify signs of peripheral artery disease. We inspect for calluses, pressure ulcers, blisters, cracks, and any open wounds. Patients with diabetes should have a professional foot exam at least once per year — more frequently if neuropathy or circulation problems are present. Regular exams near Farmington Hills significantly reduce the risk of infection, ulceration, and amputation. Same-week appointments are available.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.