Michigan Diabetic Foot Care — Why Annual Podiatry Exams Are Critical

Your Annual Foot Exam Is the Most Important Preventive Step You Can Take

Michigan’s diabetes rate is above the national average. Livingston and Oakland Counties have growing diabetic populations. And the data is unambiguous: diabetic patients who receive annual podiatry foot exams have dramatically lower rates of ulceration, hospitalization, and amputation than those who don’t. At Balance Foot & Ankle in Howell and Bloomfield Hills, we see this difference daily — patients who come in consistently stay healthier, and those who only come when something’s wrong arrive with problems that could have been prevented. Call (810) 206-1402. Our Bloomfield Hills office shares a building with the Grunberger Diabetes Institute for coordinated diabetic care.

The Statistics That Make Annual Exams Non-Negotiable

Diabetic patients without regular foot care are 15 times more likely to undergo lower limb amputation than those with consistent podiatric monitoring. Over 80% of diabetic amputations are preceded by a foot ulcer that could have been identified and treated before progressing to amputation — with regular monitoring. Michigan-specific data mirrors national trends: roughly 40,000 diabetes-related amputations occur annually in the US, and the vast majority are preventable with routine care. The math is clear — one annual exam versus potentially losing a limb.

What We Check at Every Diabetic Foot Exam

Our comprehensive diabetic foot exam is not a cursory glance — it’s a systematic assessment covering every element of diabetic foot risk:

Neuropathy screening. Monofilament testing to assess protective sensation (the ability to feel a 10-gram force — the threshold below which wound risk rises dramatically). Vibration threshold testing using a tuning fork. Clinical assessment of reflexes, proprioception, and temperature sensation. This catches neuropathy early — often before patients are aware of significant changes.

Vascular assessment. Dorsalis pedis and posterior tibial pulse palpation. Capillary refill time. Skin temperature and color assessment. Ankle-brachial index (ABI) when peripheral arterial disease (PAD) is suspected. PAD is present in 30–40% of diabetic patients and dramatically increases complication risk.

Structural assessment. Evaluation of foot shape changes — hammertoes, bunions, Charcot deformity, arch collapse. These create pressure points that, in neuropathic feet, lead directly to ulcers.

Skin and nail assessment. Callus location and severity (thick callus overlies high-pressure points and can harbor developing ulcers). Skin condition — dryness, cracks, maceration between toes. Nail assessment for thickening, onychomycosis (fungal), and ingrown nails that diabetic patients may not feel but can cause serious infection.

Wound identification. Some diabetic patients arrive with wounds they haven’t noticed because they can’t feel them. Early detection and treatment of wounds prevents the devastating progression to serious infections.

Footwear assessment. We evaluate your current shoes and socks for fit, support, and pressure points — and address problems before they cause injury.

What Medicare Covers

Medicare Part B covers one routine diabetic foot exam per year for patients without a designated foot care provider. Patients with documented peripheral neuropathy qualify for exams every 6 months. Additionally, Medicare covers the Medicare Therapeutic Shoe Program (one pair of diabetic shoes plus inserts annually), nail care for patients with qualifying systemic conditions, and diabetic wound care when needed. We handle all Medicare documentation and billing — you show up, we handle the rest. Call (810) 206-1402 and we’ll verify your Medicare benefits before your first appointment.

When to Come in More Often Than Annually

Annual exams are the minimum. If you have any of the following, we recommend more frequent visits: active neuropathy with significant sensory loss, previous foot ulcer or amputation, peripheral arterial disease (PAD), Charcot foot (any stage), active toenail fungus or skin conditions, or any wound — no matter how small. For high-risk patients, quarterly or monthly visits are appropriate and may be covered by Medicare.

Between Your Annual Exams — Daily Foot Care

The annual exam catches what you might miss; daily home monitoring is what prevents emergencies. Every diabetic patient should: inspect both feet daily using a hand mirror for the sole, feel for temperature differences between feet (asymmetric warmth can signal early Charcot), check for blisters, cuts, skin breakdown, or redness, wash feet in lukewarm water (not hot — neuropathic patients can’t reliably feel temperature), dry completely especially between toes, apply urea-based moisturizer to heels and dry areas (not between toes), wear clean diabetic socks daily, and check inside shoes before wearing for foreign objects. See our complete diabetic daily foot care checklist.

The Grunberger Diabetes Institute Coordination Advantage

Our Bloomfield Hills office at 43494 Woodward Ave, Suite 208, shares a building with the Grunberger Diabetes Institute — one of Michigan’s most respected diabetes centers. For Oakland County and Metro Detroit patients, this means your endocrinologist and podiatrist can communicate directly about your case. If your glycemic control is worsening and your neuropathy is progressing, we can flag this for your diabetes team immediately. If your endocrinologist identifies new vascular concerns, we can coordinate a podiatry evaluation promptly. This integration of care is rare in Michigan and represents a significant clinical advantage for our patients.

Book Your Diabetic Foot Exam Today

Don’t wait until you have a problem. Call (810) 206-1402 to schedule your annual diabetic foot exam at our Howell or Bloomfield Hills office. We accept Medicare, Blue Cross Blue Shield, United Health, Aetna, Cigna, HAP, Humana, and most major Michigan insurance plans. Same-day and next-day appointments frequently available.

Frequently Asked Questions

My feet don’t hurt — do I still need an exam? Absolutely — and the absence of foot pain in a diabetic patient with neuropathy is actually a warning sign, not reassurance. Pain is a protective mechanism. When neuropathy eliminates it, wounds develop without pain as an alert. Annual exams catch the problems your feet can’t tell you about.

My PCP checks my feet at my diabetes visits — is that enough? A brief PCP foot check is valuable but not equivalent to a comprehensive podiatric examination. We perform detailed neuropathy testing, vascular assessment, structural analysis, and footwear evaluation that cannot be replicated in a 2-minute PCP foot check. Both are important; neither replaces the other.

I have Medicare Advantage — am I covered? Most Medicare Advantage plans cover diabetic foot exams, though benefits vary. Call us at (810) 206-1402 and we’ll verify your specific Medicare Advantage coverage before your appointment — no surprises.

Related Treatment Guides

• Diabetic Foot Care
• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Medical References & Sources

• American Diabetes Association — Foot Complications
• PubMed Research — Diabetic Foot Care
• American Podiatric Medical Association — Diabetic Foot

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

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.