Diabetic Foot Exam: What To Expect

A diagnosis of Type 1 or Type 2 diabetes may have left you with a roller coaster of emotions and a big folder of information to study. One of the surprising things you are about to learn is that your podiatrist will be a key member of your new team. Diabetes can cause nerve damage, which means that you might not notice injuries to your feet that can lead to more serious problems, and diabetes can reduce the flow of blood to your feet, which means you will take longer to heal. Good foot care, both at home and with the help of your medical team, is more important than ever now.
What happens during a diabetic foot exam? The first part of a foot exam is visual and hands-on: the doctor will check for sores and for any color changes in your skin or nails, all of which will convey information about the health of your feet. The doctor will look at the bone structure of your feet and ask you about general changes you might have observed—anything from painful spots to the way your shoes fit. Some of the things you should be sure to share: burning or tingling sensations, numbness, feet that feel cold, hot, or sweaty all time, and a feeling of unsteadiness on your feet.
The doctor will then bring out some instruments to do some tests. Here are some of the common ones:

• Monofilament test: The simple tool used in this test is basically a thin flexible wire. The doctor will test it on your hand first by gently pressing the tip of the instrument down on your palm so you can see how it feels (it’s painless), and then on the bottom of your big toe and three spots on the ball of your foot to test your foot’s ability to feel pressure.

• Vibration testing: Some patients who can feel the monofilament may still be at risk for diabetic nerve loss, so your doctor might follow up with vibration test to double-check the feeling in your foot. In vibration testing the doctor holds the handle of a vibrating tuning fork against your foot; if your nerves are functioning properly you’ll feel a tickle.

• Ankle reflexes: Diabetic neuropathy can affect your ankles as well as your feet; your doctor may tap on your ankle while your foot is flexed to see if you react. Any kind of diabetic neuropathy puts you at risk because, with a diminished ability to feel pain, you might not be aware of a sore or injury until it has become serious.

• Circulation check: Depending on your symptoms your doctor may also want to assess the blood flow in your feet, first by checking the pulse in your feet and then doing an ABI or Ankle-Brachial Index test, essentially taking your blood pressure in your arm as usual then taking it in your ankle and comparing the two readings.

These simple, painless, and non-invasive tests will tell your doctors a lot and will help them put together an effective program of care. The most important gift you can give yourself is to take your diabetes foot care seriously, follow a regimen of home care and self-examination—check your feet daily, take care of any wounds immediately, keep your feet clean and dry, and visit your foot doctor regularly. For more information about foot health or to make an appointment with one of Triad Foot & Ankle Center’s highly skilled podiatrists, please call 336.375.6990 or click here to request an appointment at one of our four office locations.

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