Why Patients with Diabetes Need Regular Podiatric Care

Understanding Diabetic Foot Problems

Diabetes affects the feet in two primary ways: neuropathy and poor circulation. Understanding both is key to understanding why routine exams matter so much.

Diabetic neuropathy is nerve damage caused by prolonged high blood sugar. It often starts in the feet and can cause tingling, burning, numbness, or a complete loss of sensation. When you can't feel your feet normally, you may not notice a cut, blister, or sore until it has already become infected. That's a serious problem, because infections in the feet of diabetic patients can escalate quickly.

Poor circulation, also called peripheral vascular disease, is another common complication of diabetes. When blood flow to the feet is reduced, the body has a harder time delivering the oxygen and nutrients needed to fight infection and repair tissue. A wound that would heal quickly in a healthy person may linger for weeks or months in someone with diabetes, and in severe cases, it may not heal at all.

Together, neuropathy and poor circulation create conditions where foot ulcers can develop and worsen without warning. Diabetic foot ulcers are one of the leading causes of hospitalization among people with diabetes, and they are a major contributor to lower limb amputations. The vast majority of these outcomes are preventable with proper monitoring and care.

That's why the American Diabetes Association and most podiatric organizations recommend that patients with diabetes receive a comprehensive foot exam at least once a year, and more often if they have a history of ulcers, neuropathy, or circulation problems. At Council Bluffs Foot & Ankle Care, Dr. Barnes provides these exams with the thoroughness and attention to detail that diabetic patients deserve.

What to Expect From a Diabetic Foot Doctor Near You

What Happens During a Diabetic Foot Exam

A diabetic foot exam at our Council Bluffs office is a comprehensive evaluation that looks at multiple aspects of your foot health. Here is what Dr. Barnes assesses during each visit.

Skin & Nail Assessment

Dr. Barnes examines the skin on your feet for dryness, cracking, calluses, blisters, and open sores. He checks between your toes for signs of fungal infection, which can create entry points for bacteria. Your toenails are also evaluated for cracks, thickening, or signs of fungal infection.

Neurological Testing

To assess nerve function, Dr. Barnes uses several simple tests:

• Monofilament test: A soft nylon fiber is brushed across your foot and toes to test your sensitivity to light touch.
• Tuning fork test: A tuning fork is placed against your foot and toes to check whether you can feel vibration.
• Pinprick test: The bottom of your foot is gently pricked with a small pin to evaluate sensation.
• Reflex test: Your reflexes are checked by tapping your foot with a small mallet, similar to the reflex test done at a routine physical.

These tests help identify areas of numbness or reduced sensation that could put you at greater risk for unnoticed injury.

Vascular Assessment

Dr. Barnes evaluates the circulation in your feet by checking the pulses in your foot and lower leg. If there are signs of reduced blood flow, additional evaluation may be recommended to get a clearer picture of your vascular health.

Musculoskeletal Evaluation

The structure and shape of your feet are also reviewed. Conditions like bunions, hammertoes, or high arches can create pressure points that increase the risk of ulcer formation. If Dr. Barnes identifies any structural concerns, he'll discuss whether orthotic devices or other interventions may help reduce your risk.

Footwear Review

Shoe fit matters enormously for diabetic patients. Ill-fitting footwear is a common cause of blisters, calluses, and pressure sores. Dr. Barnes will ask about your shoes and may make recommendations to help protect your feet between visits.