Checking your blood glucose level, taking your medications, eating a healthful diet and exercising are likely a part of your daily routine if you have diabetes. But there's one area you might be overlooking—your feet.

It's important to pay special attention to your feet for a number of reasons. First, diabetes can lead to nerve damage in the feet (peripheral neuropathy), which, in turn, can reduce your ability to feel sensations, like cold, heat or pain. Second, diabetes can impair circulation and wound healing by hardening and narrowing the arteries that supply blood to the legs (peripheral arterial disease, PAD).

A wound on your foot that doesn't heal can turn into an ulcer that may become infected. And if you have severe peripheral neuropathy, you may not even know it's there. Left untreated, or if treatment is unsuccessful, amputation may be required in severe cases.

Get an annual foot exam

The American Diabetes Association recommends that everyone with diabetes should have their feet inspected by their primary care physician or podiatrist at least once a year. If you already have foot complications, you'll need more frequent checks.

At the exam, the doctor will inspect your feet, looking for ulcers and problems that can lead to the development of ulcers, such as cuts, sores or certain foot deformities. She or he will also check the pulses in your feet to determine if you have sufficient blood flow.

The doctor will also assess whether you're still able to feel sensations such as pain or vibration on the bottom of your feet. A simple way to do this is to gently prick the bottom of your foot with a sterile disposable pin or to hold a vibrating tuning fork against it.

For a more accurate determination, these tests should be performed in conjunction with a 10-g monofilament test. The monofilaments used for this test are constructed to buckle when 10 times the force of gravity is applied. Loss of the ability to detect pressure on this test is highly predictive of nerve damage and subsequent ulceration.

Your doctor may perform an ankle-brachial index test to screen for PAD, which often causes no symptoms in the early stages. For this test, she or he will take your blood pressure at your ankles and arms while you are at rest. If the blood pressure at your ankle is lower than the blood pressure at your arm, you will need to be evaluated for PAD.

Publication Review By: Rita Rastogi Kalyani, M.D., and Simeon Margolis, M.D., Ph.D.

Published: 24 Jul 2013

Last Modified: 11 Sep 2015