Foot Exam: Richard A. Jackson, M.D.

One in four people with diabetes will develop foot problems that require treatment. You can develop different types of foot problems, but all can lead to serious complications if left untreated. Diabetes can damage the nerves in your feet, causing you to lose your ability to feel pain or discomfort. This is called diabetic neuropathy.

Diabetes can also cause circulation problems, which can prevent you from healing as quickly as people without diabetes do.

The Joslin Clinical Guidelines recommend that you have your feet checked at least annually for altered sensation, decreased circulation and/or infection.

There are several parts of a foot exam. First, the doctor performs a visual inspection, looking for skin color changes, cuts and other damage. The doctor will then take a look between your toes, because often infections can start there. The doctor will also take a pulse at key points of the foot to determine the level of circulation. There will also be a test of sensation, where the doctor may use a tuning fork, a pin wheel or a tool called a tin gram fiber to evaluate your awareness of touch, dull versus sharp pain, movement of the tool across the skin and so on.

If you already have diabetic neuropathy, you need to inspect your feet daily and look for cuts, blisters, sores, signs of infection or changes in color or temperature. People who have neuropathy are more likely to have the more significant foot complications. Smoking has a huge impact on the likelihood of people with diabetes developing foot complications because it affects the circulation and causes nerve damage. So if you still light up, please stop as soon as possible.

So what else can you do to protect your feet? We have already talked about smoking and the need to stop. Have regular foot exams and if you have diabetic neuropathy check your feet daily.

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