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Dec. 29, 2025

Diabetic foot exam: what it is and what to expect

Maria Vinegar, NP

Medically reviewed by:
Maria Vinegar, NP

If you have diabetes, caring for your feet is more important than you might think. A diabetic foot exam helps your provider check for early problems that can become serious if untreated.

In this article, you will learn what a diabetic foot exam is, when it’s done, what to expect, who needs it and why it matters.

What is a diabetic foot exam?

A diabetic foot exam is a hands-on check of your feet by a health care provider. The goal is to identify early signs of problems before they escalate into serious issues. These problems might include nerve damage (neuropathy), poor blood flow (vascular disease), skin breakdown, ulcers (open sores) or changes in foot shape.1

Chronic high blood sugar can damage the nerves and blood vessels that supply your feet. Over time, this may cause you to lose sensation or heal more slowly from cuts and sores. A diabetic foot exam helps identify these changes early, preventing ulcers and other complications.2

The exam also helps your provider determine your risk level for foot complications. That information guides how often you need foot exams or additional care.

Who needs a diabetic foot exam?

If you have diabetes (type 1 or type 2), you should have at least one diabetic foot exam every year, even if you have no foot symptoms.

However, some people need more frequent exams. You may need checks every 3–6 months if you already have:

  • Nerve damage in your feet
  • Past foot ulcers or wounds
  • Poor blood flow to the legs or feet
  • Foot deformities (like bunions or curled toes)
  • Loss of protective sensation (you can’t feel light touch or pressure)

Medicare typically covers a foot exam every six months for people with diabetes who have nerve damage or circulation problems.3 This makes it easier to stay on top of your foot health and get ahead of potential problems. Regular exams are part of preventive diabetes care and help your provider manage any changes before they become serious.

How to know if you need a diabetic foot exam

You should schedule a foot exam right away if you notice:

  • A blister, cut or sore that doesn’t start to heal in a few days
  • Redness, warmth, swelling or pain in your foot
  • Black or foul-smelling tissue (possible gangrene)
  • Thick, cracked or discolored toenails
  • Numbness, tingling or burning in your feet
  • Changes in foot shape, such as curled toes or a flattened arch

Even if you don’t notice any of these changes, keep your regular foot exams. Many foot problems begin quietly, without pain — especially if you already have nerve damage.4

What to expect at a diabetic foot exam

Here’s what typically happens during a diabetic foot exam.

Medical history and questions

Your provider will ask about your blood sugar control, medications, any past foot problems, pain or numbness in your legs or feet and the type of shoes you wear.

Inspection of skin and nails

Your provider will carefully check both feet — the tops, bottoms, between the toes and around the ankles. They’ll look for cuts, cracks, calluses, blisters, ulcers, nail infections, dryness, color changes or temperature differences.

Neurological (nerve) tests

These tests assess your ability to feel touch, vibration and pressure in your feet. They may include:

  • Monofilament test: A thin nylon strand presses lightly on different areas of your foot. You close your eyes and say when you feel it.
  • Vibration test (tuning fork or device): A tuning fork vibrates on a toe bone. You tell the provider if you feel it.
  • Pinprick test: A small pin that doesn’t break the skin touches your toe. You say if it feels sharp or dull.
  • Ankle reflex test: The provider taps your Achilles tendon with a reflex hammer. Your foot should move slightly if your nerves are working well.

These tests help find loss of protective sensation — meaning you might not feel pain or pressure that would usually alert you to an injury.5

Vascular (blood flow) exam

Good blood flow is essential for healing. Your provider will check the pulses in your feet — the dorsalis pedis (on top of the foot) and the posterior tibial (inside the ankle). If those pulses are weak or missing, you may need more testing, such as an ankle-brachial index (ABI).

Musculoskeletal (structure) exam

Your provider will look at the shape and movement of your feet, toes and joints. They’ll check for hammertoes, bunions, Charcot foot or limited joint movement that could increase pressure points or the risk of ulcers.

Risk assessment and planning

Based on all the findings, your provider will determine your risk of developing ulcers or infections. They’ll recommend how often you need follow-up exams and may refer you to a podiatrist or vascular specialist if required. You might also receive treatment such as custom shoes, wound care or imaging.

Education and self-care advice

Before you leave, your provider should review how to check your feet at home each day, how to choose proper footwear, how to care for your skin and how to know when to call for help if you find a sore or injury.

You don’t need to fast or do anything special to prepare. If your provider finds a serious problem, such as an ulcer or infection, you may need additional tests or treatment.

What your provider looks for and what happens next

During the diabetic foot exam, your provider carefully checks for signs that could lead to serious foot problems. They’ll look for:

  • Areas with no or weak sensation (nerve damage)
  • Weak or absent pulses (poor blood flow)
  • Cuts, ulcers or wounds
  • Skin breakdown, calluses, cracks or dryness
  • Nail infections or fungus
  • Deformities (hammer toes, bunions and Charcot foot)
  • Differences in foot temperature or color
  • Signs of infection (redness, swelling or warmth)

After the exam, your provider uses this information to:

  • Assign your risk category (low, moderate or high)
  • Decide how often you’ll need follow-up exams
  • Refer you to a podiatrist or vascular specialist, if needed
  • Recommend protective footwear or orthotics
  • Begin treatment for wounds, infections or ulcers
  • Monitor changes over time
  • Teach you how to care for your feet and prevent complications

If you’re considered high risk, you may need to see a foot specialist more often for monitoring.6

Why diabetic foot exams are important

Here are key reasons:

Prevention of serious complications

A foot ulcer that goes unnoticed or untreated may lead to infection, bone involvement or even amputation. Regular foot exams allow your provider to spot changes early and act before serious problems develop.

Silent progression

Since nerve damage can make your feet numb, you might not feel pain from a blister, cut or sore. Routine checks catch issues before they turn into infections or ulcers.

Better healing

If blood flow is poor, wounds heal more slowly. Detecting vascular issues early allows your provider to recommend treatments or lifestyle changes that support circulation and wound healing.

Reduced healthcare burden

Foot ulcers and amputations lead to hospital stays, added costs and lower quality of life. Preventing them helps you stay independent and avoid unnecessary medical care.

Meeting standards and quality care

Medicare and clinical programs track whether people with diabetes receive regular foot exams. These measures help ensure your care follows national diabetes management guidelines.7

Because of all this, diabetic foot exams are a key part of long-term diabetes management.

When to schedule your diabetic foot exam

Most people with diabetes should have a diabetic foot exam at least once every year. If you have nerve damage, poor circulation or a history of foot ulcers, your provider may recommend exams every three to six months.

Most Medicare plans cover a foot exam every six months for people with diabetes who have nerve damage or circulation problems. This makes it easier to stay consistent with preventive care and avoid serious complications.

Even if your feet feel fine, it’s safest to keep a regular schedule — many foot problems develop quietly before symptoms appear.

How to prepare for a diabetic foot exam

You don’t need any special preparation before your diabetic foot exam, but a few simple steps can help you get the most from your visit:

Before your appointment:

  • Wear the shoes and socks you typically use so your provider can check their fit and condition.
  • Bring your medication list and any notes about foot changes, pain, sores or numbness.
  • Be prepared to remove your shoes and socks for the exam.
  • Be prepared to ask your provider to explain your results and how often you’ll need follow-up exams.

At home, between visits:

  • Check your feet daily for cuts, redness, swelling, blisters or nail changes.
  • Wash with mild soap and warm (not hot) water, then dry carefully, especially between your toes.
  • Apply lotion to keep your skin soft (avoid putting lotion between toes).
  • Trim toenails straight across or ask your provider for help if needed.
  • Wear well-fitting shoes and clean socks every day.
  • Avoid walking barefoot, even indoors.
  • Keep your blood sugar levels within target range.
  • Stay active to support circulation and foot health.

These habits help protect your feet between exams and make your provider’s job easier when checking for early signs of problems.8

Common questions and myths

Does the exam hurt?

No. It’s painless and noninvasive.

Do I need to fast or stop medications?

No. You don’t need any special preparation.

Will Medicare pay for it?

Most Medicare plans cover a foot exam or treatment every six months if you have diabetes-related nerve damage to the lower legs and feet. However, routine foot care is generally not covered if you don’t have qualifying conditions.

If I have no symptoms, why bother?

Since nerve damage can make you unable to feel pain, many problems start without you realizing. The exam catches complications early.

Summary & take-home points

  • A diabetic foot exam is a safe, routine check of your feet to spot early problems.
  • You should have one at least once a year, more often if you have risk factors.
  • The exam checks your skin, nerves, blood flow and bone structure.
  • Providers look for ulcers, nerve damage and infections.
  • Results guide next steps and preventive care.
  • Daily home checks, good shoes and regular primary care visits help keep your feet healthy.

If you or someone you care for has diabetes, it’s wise to ask: “When was my last diabetic foot exam? At WellMed, we believe in catching trouble early when treatment is simpler. You deserve safe, healthy steps — so don’t skip your foot check.

References

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