# Diabetes foot check > A diabetes foot check looks for early signs that diabetes is affecting your feet, such as nerve damage, poor circulation or changes in foot shape, before a sore forms. It gives you a risk category that sets how often you're checked and what care you need. Guide in [Checks and tests](https://footanklelowerlimb.com.au/learn/topics/checks-and-tests), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/diabetes-foot-risk-assessment Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's a check for early foot problems.** A trained health professional looks at your nerves, circulation and foot shape to judge how likely a foot ulcer is. - **Most people with diabetes need one at least once a year,** and more often when their risk is higher. - **It's a hands-on check with your shoes and socks off,** and it ends with a risk category and advice. - **No test is perfect,** so a normal result doesn't mean new changes can wait. ## What is a diabetes foot check, and what is it for? A diabetes foot check (the clinical name is diabetes foot risk assessment, also called foot screening) looks for signs that diabetes is changing your feet in ways that could lead to a foot ulcer (an open sore) and, through that, amputation [1]. The aim is to find problems early, before a wound forms [2]. It focuses on nerve damage (which can dull your feeling), poor circulation (peripheral artery disease) and changes in foot shape. It also takes in any past ulcer or amputation [3]. The clinician then uses what they find to judge your risk of an ulcer and place you in a risk category [4]. ## Who needs a diabetes foot check, and how often? Everyone with diabetes should have their feet checked at least once a year by a trained health professional, such as a GP, podiatrist or diabetes educator [5]. People at very low risk are checked yearly for loss of feeling and circulation problems, and people at higher risk are checked more often [6]. The Australian guideline repeats checks every 6–12 months for IWGDF risk 1, every 3–6 months for risk 2 and every 1–3 months for risk 3 [5]. (IWGDF is the international group whose risk levels are used.) Your clinician will tell you which level you're at. Because of Australia's size, some people can't get a timely check [5], so if yours is overdue, ask your GP what's available. ## What happens during a diabetes foot check? The check usually follows the same steps each time, with your shoes and socks off [7]. - **Looking.** The clinician checks for sores and for any change in the shape of your foot [7]. - **Testing feeling.** This is usually done with a monofilament (a thin, flexible filament pressed against your skin) [7]. A simple alternative is the Ipswich Touch Test, a light touch to your toes that needs no equipment [8]. - **Checking circulation.** The clinician feels the pulses in your feet [7]. A hand-held Doppler (a small ultrasound device) is useful if available, but the check can be done without one [9]. - **Risk category and advice.** You're told your category and given advice [7]. Foot-care education is recommended for everyone with diabetes [10]. ## What do the results mean, and how accurate is the check? Your category comes from the findings above: nerve damage, circulation, foot shape, and any past ulcer or amputation [3]. The higher your category, the more often you're checked [5]. You may also be offered education suited to you, and advice on protective footwear fitted by someone trained [5]. Category names and intervals can differ between services, so follow the plan your clinician gives you. If you've had an ulcer, an amputation or Charcot foot (a condition affecting the bones and joints of the foot), you're in the "in remission" group. Your risk of further ulcers is very high, even when your foot looks healthy, so you need ongoing regular review [11]. If early signs of reduced circulation are found, stopping smoking and keeping walking are the first steps, and your GP can advise [9]. The tests are better at confirming a problem than ruling one out. A normal monofilament or Ipswich Touch Test doesn't rule out nerve damage [12][8], and a normal ankle-brachial index (a blood pressure comparison at the ankle) doesn't rule out artery disease [13][14]. Results also depend on the clinician's technique and training [15]. ## What are the limits of a diabetes foot check, and are there alternatives? These checks can reliably pick out the people at highest risk of an ulcer, but it isn't clear yet whether screening itself prevents limb loss [16]. Because each test can miss things, clinicians combine your history, a look at your feet, sensation tests and pulses rather than relying on one result. If an ankle-brachial index may be unreliable, for example when artery walls are stiffened by calcium, a toe-brachial index (a blood pressure check at the toe) may be less affected [17]. A podiatrist or foot care team can look further when the picture is unclear. Most of this information is about adults. If the check is for a child, or you're pregnant, ask your GP or podiatrist what applies. ## When to see a podiatrist Don't wait for your next check if something changes. Pain is an unreliable warning, because nerve damage can hide problems and Charcot foot can be painless [10]. > [!tip] Try this > Look at your feet every day, or ask a partner or carer to. Check for a break in the skin, fluid, colour change or redness, new swelling or new pain. Don't burst blisters or try to remove hard skin or corns yourself; see a podiatrist instead. Call 000 and ask for an ambulance if your foot or leg suddenly turns cold and pale or blue, or if you have a foot wound or infection with confusion, severe shivering or muscle pain, passing little or no urine, severe breathlessness, or mottled skin. Go to the nearest emergency department if you have a foot infection that's spreading fast with a fever and you feel very unwell, a black or smelly foot (possible gangrene), a deep ulcer showing bone, joint or tendon, or a deep infection with purple colour or lots of pus [18][19]. See your GP or a podiatrist the same day if you have a wound, sore, blister or colour change on your foot; spreading redness, heat, swelling or pus; a hot, swollen, red foot, even without pain [10]; severe foot or ankle pain [20]; pain in your leg or foot at rest; or sudden severe pain or numbness in a leg or foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. If you haven't had a foot check in the past year, book one with your GP or a podiatrist. ## Common questions ### Who can do a diabetes foot check? A trained health professional can do it, such as your GP, a podiatrist or a diabetes educator. If your result puts you in a higher risk category, a podiatrist often takes over your regular reviews. Ask your GP who offers checks near you if you're not sure where to go. ### What does the 10 g monofilament test show? It shows whether you can feel a light, steady pressure on your skin, which helps detect nerve damage in your feet. It's one test among several, alongside looking at your feet and feeling your pulses, so your clinician reads it together with everything else they find. ## Further reading - [Diabetes foot check on Clindice](https://clindice.com/diabetes-foot-risk-assessment) - [Diabetic Foot Exam: MedlinePlus Medical Test](https://medlineplus.gov/lab-tests/diabetic-foot-exam/), MedlinePlus - [Footcare Advice | Information Site](https://mydiabetesmyway.scot.nhs.uk/resources/internal/footcare-advice-for-diabetes/), NHS - [Diabetic foot assessment - Bradford District Care NHS Foundation Trust](https://www.bdct.nhs.uk/diabetic-foot-assessment/), NHS - [Personal Footcare Guidance](https://www.publications.scot.nhs.uk/files/dl-2024-34.pdf), NHS ## Sources 1. Foot screening for individuals with Diabetes is changing · Information Site. https://mydiabetesmyway.scot.nhs.uk/for-you/news/foot-screening-for-individuals-with-diabetes-is-changing/ 2. Measurement Properties of Instruments Used to Assess Diabetic Foot: An Umbrella Review · Kim N, Song Y · Journal of Diabetes Research · 2026. https://doi.org/10.1155/jdr/3322840 3. Risk stratification systems for diabetic foot ulcers: a systematic review · Monteiro-Soares M, Boyko EJ, Ribeiro J et al. · Diabetologia · 2011. https://doi.org/10.1007/s00125-010-2030-3 4. Do we screen, examine or assess to identify the "at-risk" foot in diabetes-time for agreed terms and definitions? · Pallin JA, Van Netten JJ, Kearney PM et al. · Diabetic Medicine · 2023. https://doi.org/10.1111/dme.14976 5. Australian guideline on prevention of foot ulceration: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease · Kaminski MR, Golledge J, Lasschuit JWJ et al. · Journal of Foot and Ankle Research · 2022. https://doi.org/10.1186/s13047-022-00534-7 6. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update) · Bus SA, Sacco ICN, Monteiro-Soares M et al. · Diabetes/metabolism Research and Reviews · 2024. https://doi.org/10.1002/dmrr.3651 7. Diabetic Footcare - South & West · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/endocrinology/diabetic-footcare 8. Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis · Zhao N, Xu J, Zhou Q et al. · BMJ Open · 2021. https://doi.org/10.1136/bmjopen-2020-046966 9. Guidelines in Support of Diabetic Foot Assessments · NHS. https://www.nhsborders.scot.nhs.uk/media/500906/3_guidelines_supp_diab_foot_assessments.pdf 10. Management of Diabetic Foot · NHS. https://www.rightdecisions.scot.nhs.uk/media/rlckffzy/1287_diabetes_management_foot_problems_v1.pdf 11. Looking after your foot in remission · Information Site. https://mydiabetesmyway.scot.nhs.uk/resources/internal/looking-after-your-foot-in-remission/ 12. Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis · Wang F, Zhang J, Yu J et al. · Journal of Diabetes Research · 2017. https://doi.org/10.1155/2017/8787261 13. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review · Chuter V, Schaper N, Mills J et al. · Diabetes/metabolism Research and Reviews · 2024. https://doi.org/10.1002/dmrr.3683 14. Estimating the diagnostic accuracy of the ankle-brachial pressure index for detecting peripheral arterial disease in people with diabetes: A systematic review and meta-analysis · Chuter VH, Searle A, Barwick A et al. · Diabetic Medicine · 2021. https://doi.org/10.1111/dme.14379 15. Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses · McIllhatton A, Lanting S, Lambkin D et al. · BMJ Open Diabetes Research & Care · 2021. https://doi.org/10.1136/bmjdrc-2021-002528 16. Effectiveness of screening for foot complications in people with diabetes - A systematic review · Staniszewska A, Jones A, Rudd S et al. · Journal of Diabetes and Its Complications · 2024. https://doi.org/10.1016/j.jdiacomp.2024.108865 17. Toe-brachial index and toe systolic blood pressure for the diagnosis of peripheral arterial disease · Tehan PE, Mills J, Leask S et al. · The Cochrane Database of Systematic Reviews · 2024. https://doi.org/10.1002/14651858.cd013783.pub2 18. Australian Diabetes Foot Network: management of diabetes-related foot ulceration - a clinical update · Bergin SM, Gurr JM, Allard BP et al. · The Medical Journal of Australia · 2012. https://doi.org/10.5694/mja11.10347 19. Diabetic foot management · NHS · 2024. https://www.rightdecisions.scot.nhs.uk/nhs-borders-clinical-guidelines/diabetes-and-endocrinology/diabetic-foot-guidance/diabetic-foot-management/ 20. Diabetes and foot problems · Health New Zealand | Te Whatu Ora. https://www.healthnz.govt.nz/health-topics/conditions-treatments/diabetes/diabetic-foot-problems --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.