What to Expect During a Foot Exam
Regular foot examinations are a critical component of your health care when you have type 1 diabetes or type 2 diabetes. In addition to regular foot exams by your primary care physician, people who have a history of foot problems may need to visit a podiatrist or other foot care specialist as frequently as every 1 to 3 months.
Here’s what you should expect during your next visit.
Questions about Your General Foot History
Your doctor or podiatrist will want to get a sense of the kinds of foot problems and challenges you have faced since your last visit. He or she may ask you questions such as:
- Have you experienced any recent pain or problems in your feet?
- Do your feet tingle, itch, feel numb, feel abnormally cold or hot, or sweat profusely?
- Do you have difficulty walking or standing for extended periods?
- Are you using any foot creams or medications for ulcers, sores or other foot problems?
- Do you smoke?
Physical Examination for Foot Problems
Another important part of your foot exam is a general inspection of your feet. Your healthcare professional will look for abnormalities in appearance. If you have noticed any changes in your feet, even if they seem minor, this is a great time to bring them up.
Your doctor or podiatrist will look for both dermatological changes and deeper changes in your foot’s bone structure. Skin abnormalities might include discoloration, thickened skin, cracking, dryness, sweating, calluses, or blisters. Musculoskeletal abnormalities might include foot deformities like hammertoes, claw toes, or Charcot’s foot, a serious condition in which the foot becomes red and swollen due to bone dislocations in the foot or ankle.
Because nerve damage is common in people with diabetes, your doctor may also conduct tests to assess the nerve response in your feet. A number of techniques may be used to gauge nerve function. Alert your doctor if you experience any discomfort while these tests are being performed. These tests might include:
- Monofilament test: A thin, flexible instrument is pressed against different areas of the foot; people with nerve damage may not be able to feel the light pressure.
- Ankle reflexes: Your doctor will have you kneel or rest on the exam table or other surface; a tendon hammer is used to gently strike the ankle and test for reflexes.
- Vibration testing: Your doctor may use a tuning fork to gauge your ability to detect vibrations in the foot.
- Pinprick tests: A small disposable pin is stuck into the foot to determine your ability to perceive the prick. It is very thin and should not hurt excessively.
Finally, depending on your symptoms, your doctor may also wish to conduct circulation tests in your feet to assess blood flow in the area. This may be done by checking for pulses in your feet, or using an Ankle-Brachial Index (ABI) test, which involves taking your blood pressure in your arms and ankles and comparing the readings.
Your doctor or podiatrist may use a combination of these tests and exams, depending on your symptoms and foot health history. Early detection of injuries, infections, nerve damage, and circulation problems can be critical in helping you prevent and treat further diabetes-related foot problems.