Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
For Hartland 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 Hartland.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Diabetic Foot Exam Near Hartland, MI
Comprehensive diabetic foot exams near Hartland, MI are available at Balance Foot & Ankle in Howell. Dr. Biernacki DPM performs the full ADA-recommended annual diabetic foot evaluation — 10-gram monofilament neuropathy screening, ankle-brachial index vascular assessment, ulcer risk stratification, and nail/skin care — with the goal of preventing the 85% of diabetic amputations that are avoidable. Call (810) 206-1402.
Why Your Annual Diabetic Foot Exam Is One of the Most Important Appointments You’ll Keep
85% of all lower extremity amputations in diabetic patients are preceded by a foot ulcer — and the vast majority of those ulcers are preventable with proper foot monitoring and timely intervention. The problem: diabetic peripheral neuropathy eliminates the pain signal that normally tells you when something is wrong. A blister, pressure sore, or infected nail that would be immediately painful and obvious in a non-diabetic patient can go completely unnoticed for days or weeks in a patient with neuropathy — progressing from a small wound to deep tissue infection to osteomyelitis in that window. The ADA recommends comprehensive foot examination at least annually for all diabetic patients with established neuropathy or vascular disease — and every visit for higher-risk patients. In our Hartland-area diabetic patient population, the most consistent finding: patients who come in annually have dramatically lower rates of serious foot complications than those who wait until something hurts. Neuropathy patients often don’t feel problems — so they don’t know they have them. Regular podiatric evaluation is the substitute for that pain signal.
Key Takeaway: 85% of diabetic amputations are preventable. Annual diabetic foot exam identifies neuropathy grade, vascular status, and pressure risk before ulcers develop. Never cut diabetic toenails with scissors at home — single laceration can start an infection chain. Warm swollen diabetic foot with minimal pain = Charcot neuroarthropathy until proven otherwise. Daily self-inspection is essential between annual visits.
What the Comprehensive Diabetic Foot Exam Includes
Neuropathy screening (Semmes-Weinstein 10-gram monofilament): Tests protective sensation at 10 standardized sites on the plantar surface. Loss of sensation at ≥1 site = significant neuropathy, high ulcer risk. Vibration perception threshold testing with tuning fork (128 Hz) at the first MTP. Vascular assessment (Ankle-Brachial Index): ABI <0.9 = peripheral arterial disease, high wound healing risk. ABI >1.3 = medial arterial calcification (common in diabetes), non-compressible — toe-brachial index needed. Capillary refill, skin temperature, hair loss assessment. Dermatologic examination: Skin integrity check for pre-ulcers, callus over pressure points (callus = #1 precursor to plantar ulcer — debrided at every visit), interdigital maceration. Nail examination: Thickened mycotic nails — nail drilling and topical antifungal or systemic terbinafine. Ingrown nails — professional treatment only, never home cutting. Structural assessment: Hammertoes, bunions, Charcot deformity — high-pressure areas requiring protective footwear or orthotics. Ulcer risk stratification: Low risk (sensation intact, no deformity) → annual visit. Moderate risk (neuropathy OR deformity) → semi-annual. High risk (neuropathy + deformity OR prior ulcer) → every 1–3 months.
⚠️ Diabetic Patients — See a Podiatrist Immediately If:
- Any open sore, wound, blister, or skin break on the foot — even painless, even small
- Warm, red, swollen foot — Charcot neuroarthropathy or infection, requires same-day evaluation
- Red streaking from a wound, fever, or chills with foot wound — spreading infection, ER urgency
- Toenail that has cut into the skin — diabetic ingrown nail = infection risk, never self-treat
- Numbness or tingling that has changed — worsening neuropathy needs re-evaluation and HbA1c review
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 Hartland
Our Howell office at 4330 E Grand River Ave, Howell, MI 48843 is about 10 minutes from Hartland via US-23 or M-59. We accept most major insurance. Call (810) 206-1402 or book online.
Diabetic Patient? Schedule Your Annual Foot Exam
Balance Foot & Ankle · Serving Hartland & Michigan
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
A diabetic foot exam near Hartland is a comprehensive evaluation designed to catch problems before they become serious. Our podiatrist serving Hartland 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 Hartland 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.