In short: diabetes can reduce both the feeling in your feet and the blood supply that heals them, so a small blister, cut or pressure spot can become a serious wound before you ever feel it. A diabetes foot assessment tests your sensation and circulation, checks your skin, nails and shoes, and places you in a risk category that sets how often you should be reviewed. Because diabetes is a qualifying chronic condition, many patients are eligible for a Medicare rebate through a GP Enhanced Primary Care plan.
Why diabetes affects the feet
Two long-term effects of diabetes matter most to your feet, and they compound each other.
The first is peripheral neuropathy. Over time, raised blood glucose can damage the small nerves that carry sensation from the feet. That protective sensation is what normally tells you a shoe is rubbing, a seam is pressing, a stone is in your sock, or the bath water is too hot. When it fades, the warning system fades with it. People often describe numbness, pins and needles, burning at night, or simply feet that feel distant and unfamiliar. Many people have no symptoms at all and only find out when it is measured.
The second is peripheral arterial disease. Diabetes accelerates narrowing of the arteries supplying the lower limb, which reduces the blood flow that delivers oxygen, nutrients and immune cells to healing tissue. A graze that would close over in a few days on a well-perfused foot can sit open for weeks.
Put the two together and the risk becomes clear. An injury you cannot feel goes unnoticed, you keep walking on it, and the foot has less capacity to repair the damage. This is why prevention rather than repair is the whole point of diabetic foot care, and why regular checks matter even when nothing hurts. The great majority of serious diabetes-related foot problems begin as something small and unremarkable.
What a diabetes foot assessment involves
A full assessment takes a dedicated appointment. It is comfortable, and you will leave knowing exactly where you stand.
- History. How long you have had diabetes, your recent HbA1c and glucose control, medications, kidney and eye health, smoking, any previous ulcers or foot surgery, and what you have noticed yourself.
- Skin and nail check. We look for dry or cracked skin, corns and calluses (which are pressure signals, not just cosmetic), fissures at the heel, tinea between the toes, fungal or thickened nails, and any ingrown or in-turning nail edges.
- Sensation testing. A 10g monofilament is pressed at set points on the sole to map protective sensation, and a tuning fork checks vibration perception, which is often the first sense to decline.
- Circulation checks. We palpate the pulses at the ankle and top of the foot, assess skin colour, temperature and hair growth, and note capillary refill. Where indicated we use a doppler to listen to the flow.
- Structure and pressure. Toe deformity, a collapsed or high arch, restricted joint movement and the callus pattern on your sole all show where load is concentrating.
- Footwear inspection. Bring the shoes you actually wear most. Wear patterns, internal seams, worn linings and depth in the toe box tell us a great deal.
- Risk categorisation. Findings are combined into a low, intermediate or high risk category, which sets your review schedule and your care plan.
You will also get any treatment needed on the day, such as safe debridement of callus, careful nail care, or attention to a problem nail. Where load needs to be redistributed we may discuss custom or prefabricated orthotics.
How often you should be reviewed
Review frequency follows your risk category rather than a single rule for everyone.
- Low risk (normal sensation, good pulses, no deformity or history of ulceration): a full assessment once a year.
- Intermediate risk (loss of protective sensation, or reduced circulation, or significant deformity): review every three to six months.
- High risk (loss of sensation plus poor circulation, previous ulcer or amputation, or callus over a bony prominence): review every one to three months, and sooner if anything changes.
Your category is not permanent. Glucose control, activity, weight, smoking and footwear all move the needle, so we reassess and adjust rather than assume last year’s result still holds.
Looking after your feet between visits
A two-minute daily routine
- Look at both feet every day, including between the toes and the soles. Use a mirror on the floor or ask someone to check for you if bending is difficult.
- Wash daily in warm water, then dry thoroughly, especially between the toes.
- Moisturise the tops, soles and heels, but not between the toes, where trapped moisture encourages tinea.
- Test bath water with your elbow or a thermometer, and keep feet away from heaters, hot water bottles and electric blankets.
- Never walk barefoot, indoors or out.
- Cut nails straight across and file the corners smooth. If you cannot see or reach your feet comfortably, let us do it.
- Change socks daily and choose seam-free, non-constricting styles.
Footwear that protects
Shoes are the single most common cause of injury in an insensate foot. Look for a fastening (laces, straps or velcro) so the foot is held without needing to grip, a firm heel counter, depth and width in the toe box so nothing presses on the toes, a smooth internal lining with minimal seams, and a sole that cushions without being unstable. Shop late in the day when feet are at their largest, and run a hand through the inside of every shoe before you put it on. Our podiatrist Bryce Foothead spent time managing a technical footwear store, so footwear questions are welcome at any appointment.
Warning signs that need urgent attention
Contact us or your GP the same day if you notice any of the following on your foot or lower leg:
- Any new wound, cut, crack, blister or ulcer, however small or painless
- Redness, heat or swelling, particularly in one foot and not the other
- A change in colour to pale, blue, dusky or blackened skin
- Discharge, odour or wetness in a sock or dressing
- A wound that is not clearly healing within a few days
- New or worsening pain, or a sudden change in the shape of the foot
Do not wait for your scheduled review. Early care is straightforward and effective, and delay is what turns a minor problem into a serious one.
Medicare, health funds and DVA
Diabetes is a qualifying chronic condition for a Medicare Enhanced Primary Care (EPC) plan. Ask your GP whether an EPC plan is appropriate for you; if it is, they will refer you to us and a Medicare rebate applies to those visits. We also accept all major Australian health funds with HICAPS on the spot at every clinic, so you claim your extras rebate at the appointment and only pay the gap. Visa, Mastercard and EFTPOS are accepted.
DVA Gold Card holders and WorkCover patients need a referral. Everybody else can book directly without one. If you are unsure which applies to you, call us on (03) 9111 0085 or read our frequently asked questions.
Our principal podiatrist, Gideon Poratt, has particular experience in managing foot complications caused by diabetes, alongside sports biomechanics, paediatrics and gerontology.
Common questions
Do I need a referral to see a podiatrist about my diabetes?
No. You can book directly with us at any of our clinics. A referral is only required for DVA Gold Card holders, WorkCover patients, and for Medicare-rebated visits under a GP Enhanced Primary Care plan.
My feet feel completely normal. Do I still need a check?
Yes. Nerve changes are usually painless and gradual, and reduced circulation rarely announces itself either. Both are found by testing, not by symptoms. An annual assessment establishes your baseline so any change is picked up early, while it is still easy to manage.
Can I cut my own toenails?
If you can see your feet clearly, reach them comfortably, and your sensation and circulation are intact, careful straight-across trimming is usually fine. If your vision or reach is limited, your nails are thickened or curved, or you have reduced feeling, let us do it. A nick from home nail care is a common starting point for a wound. See ingrown toenail treatment if a nail edge is already digging in.
Is a fungal nail a problem if I have diabetes?
It deserves attention. Thickened, brittle nails press on the nail bed and on neighbouring toes, and the surrounding skin can crack and let bacteria in. Our GenesisPlus Nd:YAG 1064nm laser is FDA-cleared, needle-free and has no downtime, with an approximate 85% success rate after two to three sessions. Read more about fungal nail treatment.
What should I do if I find a blister or a small cut?
Do not pop a blister or use antiseptic paints or corn pads. Cover the area with a clean, non-adhesive dressing, keep weight off it as far as you can, and contact us or your GP the same day. Small wounds on a diabetic foot are assessed promptly as a matter of routine, not as an overreaction.
Which clinic should I book?
Whichever is most convenient, as diabetes assessments are available at all four. Our St Helena and Windsor clinics offer online booking, and Windsor has lift access. See all clinic locations or book online.
This page is general information, not personal medical advice. Reviewed by Gideon Poratt, Principal Podiatrist (B.App.Sc (Pod), M.A.Pod.A), a member of the Australian Podiatry Association. Please book an assessment for advice specific to your feet.