Diabetic foot screening

Overview

Diabetic foot screening is a regular check-up to find foot problems early in people with diabetes. It helps prevent serious issues like foot ulcers or infections that could lead to amputation.

Yes, about 10% of people with diabetes will have a foot problem at some point. Many of these problems can be found early with regular screening.

Diabetic foot screening is recommended for anyone with type 1 or type 2 diabetes, especially those who have had diabetes for several years or have other health conditions like high blood pressure or high cholesterol.

Symptoms

Common symptoms

• There are often no early symptoms, which is why screening is important.
• Numbness or tingling in the feet
• Burning pain or cramps in the legs or feet
• Dry, cracked skin on the feet
• Calluses or corns that don't go away

Symptoms in children

• Children may not notice or report symptoms of foot problems.
• Look for changes in how they walk, or if they complain of odd sensations in their feet.
• Check for blisters, redness, or sores that heal slowly.

Symptoms in older adults

• Older adults are more likely to have dry, fragile skin and poor circulation in their feet.
• They may have difficulty seeing or reaching their feet to check for problems.
• Be alert for swelling, color changes, or any new sore or blister.

Causes

Main causes

• High blood sugar over time damages nerves (a condition called neuropathy), making it hard to feel pain or pressure in the feet.
• Damage to blood vessels from diabetes reduces circulation to the feet, which slows healing.

Risk factors

• Poorly controlled blood sugar levels
• Having diabetes for many years
• Smoking
• High blood pressure or high cholesterol
• Previous foot ulcers or amputations
• Being unable to see or reach your feet easily

When to see a doctor

See a doctor urgently if:

• If you notice any of the emergency symptoms listed above, call your local emergency number immediately or go to the emergency room.
• If you have a new sore or wound on your foot that is not healing, see a doctor within 24 hours.

Book a routine appointment if:

• Even if you have no foot symptoms, schedule an annual foot screening with your healthcare provider.
• If you have risk factors like neuropathy or circulation problems, you may need screening more often—ask your doctor.

Diagnosis

A qualified healthcare provider—such as a podiatrist, nurse, or doctor—will examine your feet. They will also ask about your symptoms and medical history.

Tests that may be done

• Monofilament test: a thin plastic filament is touched to parts of your foot to check if you can feel it.
• Tuning fork test: a vibrating fork is placed on your foot to test your sense of vibration.
• Pulse check: the provider feels for pulses in your feet to assess blood flow.
• Visual inspection: the provider looks for cuts, blisters, calluses, redness, swelling, or changes in foot shape.

What to expect at your appointment

The screening takes about 10 to 15 minutes. You will remove your shoes and socks. The provider will gently touch and look at your feet. There is no pain, and you can go back to your usual activities right after.

Treatment

If the screening finds a problem, treatment will depend on what is wrong. The goal is to heal the issue and prevent it from getting worse.

Self-care at home

• Check your feet every day for cuts, blisters, redness, or swelling.
• Wash your feet daily with warm (not hot) water and dry them gently, especially between the toes.
• Apply moisturizer to dry skin, but not between the toes.
• Trim toenails straight across to avoid ingrown nails.
• Always wear well-fitting shoes and never walk barefoot.

Medical treatments

Your healthcare provider may recommend special footwear or insoles to protect your feet. If you have an infection, you may be prescribed antibiotics. For neuropathy, treatments focus on managing symptoms and preventing injury. Your provider may also work with you to improve your blood sugar, blood pressure, and cholesterol levels.

When is surgery considered?

Surgery is rarely needed. It may be considered for severe infections, to remove dead tissue, or to improve blood flow to the foot. Your healthcare team will discuss all options with you.

Living with this condition

Make foot care a part of your daily routine. Check your feet each morning and evening. Look for any changes. Choose comfortable shoes that don't rub or pinch. If you have trouble seeing your feet, use a mirror or ask a family member for help.

Lifestyle tips

• Quit smoking—it seriously harms circulation in your feet.
• Keep your blood sugar, blood pressure, and cholesterol in target ranges.
• Stay active with gentle exercises like walking or swimming, but check with your doctor first.

Diet and exercise

Eat a balanced diet with plenty of vegetables, whole grains, and lean protein to help control blood sugar. Regular physical activity improves circulation and overall health. Ask your diabetes team about what is best for you.

Mental health and emotional wellbeing

Worrying about foot problems is normal, but regular screening can give you peace of mind. If you feel anxious or depressed, talk to your healthcare provider. They can connect you with support.

Prevention

Yes, most serious foot problems can be prevented with good diabetes management, regular foot screening, and daily self-care.

Screening programmes

An annual foot screening by a healthcare professional is a key part of prevention. If you have risk factors, you may need screening every 3 to 6 months.

Complications

If left untreated

• Foot ulcers (open sores) that can become infected
• Infection that spreads to the bone (osteomyelitis)
• Gangrene (tissue death) leading to amputation

Long-term outlook

The outlook is very good when foot problems are caught early. With proper screening, self-care, and medical follow-up, most people with diabetes can keep their feet healthy and avoid serious complications.

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