Diabetic foot check (Diabetic foot assessment (foot risk screening))
A simple check of your feet, done at least once a year if you have diabetes, to spot loss of feeling or poor circulation early and reduce the risk of ulcers and amputation.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It is a yearly check of feeling, circulation and skin in both feet to catch problems early.
- It does not treat anything; it sorts your feet into low, moderate or high risk to guide care.
- Because nerve damage can hide pain, you can have a serious problem without feeling it, so attending matters even if your feet feel fine.
- Most diabetes-related amputations are preventable, and early action after the check is the point of it.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Detects loss of feeling and poor circulation before they cause harm
Using the routine check in place of urgent care if you already have an active foot ulcer, infection or a hot swollen foot, which need immediate assessment.
Both feet are examined and the feeling and pulses are tested. It is usually not painful and usually takes 10 to 20 minutes.
A clearly stated risk level with tailored foot-care advice.
Both feet are examined and the feeling and pulses are tested. It is usually not painful and usually takes 10 to 20...
You are told your risk level (low, moderate or high) and given foot-care advice, with any referral arranged.
Moderate or high risk should lead to a foot protection service appointment, sometimes within a few weeks or sooner...
You look after your feet daily and seek help promptly for any cut, blister, colour change, swelling or pain that...
What is a diabetic foot check?
A diabetic foot check is a short examination of your feet that everyone with diabetes should have at least once a year. Diabetes can, over time, damage the nerves and blood vessels in the feet. Nerve damage (neuropathy) can mean you do not feel a cut, blister or stone in your shoe, while poor circulation slows healing. Together these raise the risk of foot ulcers, infection and, in the worst cases, amputation.
The check looks for early warning signs before they cause harm. A healthcare professional examines both bare feet, tests the feeling in them (usually with a soft 10 g monofilament), feels the pulses, and looks for changes in skin, shape, calluses or ulcers. They then give you a risk level: low, moderate or high.
The aim is prevention. Most serious diabetic foot problems are avoidable, and spotting reduced feeling or circulation early means you can be referred to a foot protection team and given advice before an ulcer develops. The check itself does not treat anything; it tells you and your team how much care your feet need.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Sensation (feeling) test
A soft strand called a 10 g monofilament is pressed at several points on each foot to check whether you can feel it. Loss of feeling is a key warning sign of nerve damage.
Circulation check
The pulses in your feet are felt, and sometimes a small Doppler probe is used, to check blood flow. Poor circulation slows healing.
Skin and structure examination
Both feet are looked at for cuts, blisters, ulcers, calluses, infection, changes in colour or shape, and signs of pressure from footwear.
Risk assessment and advice
Your findings are combined into a risk level (low, moderate or high), with advice on foot care and, if needed, referral to a foot protection service.
Preparing for your test
- Wear shoes and socks that are easy to remove, as both bare feet will be examined.
- Try not to use heavy moisturiser on the day, so the skin can be seen clearly.
- Bring the footwear you wear most, so it can be checked for pressure points and fit.
- Tell the team about any numbness, tingling, burning, cramp on walking, or any cut, sore or colour change you have noticed.
- Mention previous foot ulcers or amputation, or if you are on kidney dialysis, as these affect your risk level.
- Bring a list of your medicines and let them know how your diabetes control has been.
What happens
The check is usually done by a practice nurse, podiatrist or other trained professional, often as part of your annual diabetes review. You remove your shoes, socks and any dressings, and both feet are examined.
They test the feeling in your feet, commonly by touching several spots with a thin 10 g monofilament and asking whether you can feel it, and may also use a tuning fork or other simple tests. They feel the pulses in your feet to check circulation, and look closely for cuts, blisters, ulcers, hard skin, infection, swelling, and changes in colour or shape. Your footwear may be checked too.
At the end they explain what they found and give you a risk level: low, moderate or high. If you are at moderate or high risk, or have an active problem, you should be referred to a specialist foot protection service, sometimes urgently.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Using the routine check in place of urgent care if you already have an active foot ulcer, infection or a hot swollen foot, which need immediate assessment.
- Treating a normal check as a reason to stop daily self-checks.
- Relying on a rushed examination that does not remove dressings or test feeling at multiple sites.
- Assuming the check itself treats foot problems; it assesses risk and triggers care.
Delay or rearrange if…
- You have an active foot emergency (spreading redness, fever, black or cold toes), which needs urgent care now, not a routine check.
- You have an open wound that needs dressing and direct assessment first.
- There is a language or communication barrier that means advice cannot be understood, until support is arranged.
- You are acutely unwell, when assessment may be better done as part of urgent care.
Alternatives to discuss
- Daily self-examination of the feet between professional checks.
- Podiatry-led care for those at higher risk.
- Urgent referral to a multidisciplinary foot team for active problems.
- Improving blood sugar, blood pressure and cholesterol control to reduce future risk.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Detects loss of feeling and poor circulation before they cause harm
- Identifies cuts, ulcers, calluses or infection early
- Sorts your feet into a risk level so the right level of care is arranged
- Triggers referral to a foot protection team if needed
- Reinforces practical foot-care advice that helps prevent ulcers and amputation
Risks & complications
- Minor discomfort from being examined or from the tuning fork
- Finding a problem you were unaware of, which can be worrying but is the point of the check
- A normal check does not guarantee problems will not develop before the next one
- False reassurance if the check is rushed or feeling is not tested properly
- A borderline result that needs review or a repeat check sooner
- Anxiety if a high-risk result or referral is given
- Missing a developing problem between checks if foot-care advice is not followed
- A serious infection being found that needs urgent treatment
The biggest danger is a false sense of safety. Because nerve damage can remove pain, a foot can be at serious risk while feeling completely fine, and problems can develop between yearly checks. Ask what your risk level is, what it means, and exactly when you should seek help rather than waiting for the next appointment.
Published figures to discuss
The check itself carries essentially no physical risk. The figures below describe the size of the problem it is designed to prevent, drawn from UK studies, and explain why early detection matters. They are population figures, not predictions for any individual.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Lifetime risk of a foot ulcer with diabetes | Reported around 19% to 34% over a lifetime in published reviews | Risk varies widely with nerve damage, circulation, blood sugar control and previous ulcers. | Amputation-free survival in people at high risk of foot ulceration (national study) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Foot ulcers leading to amputation | Reported across a wide range, from low to over half, depending on severity and care | Prompt, specialist care substantially reduces this risk, which is why early detection matters. | Amputation-free survival in people at high risk of foot ulceration (national study) — PMCpmc.ncbi.nlm.nih.govSource-linked context |
| Loss of protective sensation | Common in longer-standing diabetes | A usually not painful blister or burn can still be serious. Patients need footwear checks and daily self-inspection. | Guide sourcesClinical context |
| Same-day referral triggers | Clinically important | Spreading infection, new ulceration, critical ischaemia, gangrene or a hot swollen foot should not wait for routine follow-up. | Amputation-free survival in people at high risk of foot ulceration (national study) — PMCpmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is nothing to recover from after a foot check. What matters afterwards is knowing your risk level, following the foot-care advice, and acting quickly on any new problem.
- No after-effects from the check itself
- Knowing your risk level and what care you need
- Being given advice on daily foot care and footwear
- Sometimes being referred on for more specialist foot care
Aftercare
- Check your own feet regularly (using a mirror or a helper for the soles) for cuts, blisters, colour change or swelling.
- Keep skin moisturised, but not between the toes, and keep nails trimmed carefully or by a podiatrist.
- Wear well-fitting shoes and never walk barefoot, especially outdoors.
- Check the temperature of bath water with your hand or elbow, as numb feet may not feel heat.
- Keep blood sugar, blood pressure and cholesterol as well controlled as you can, and stop smoking.
- Attend any foot protection or podiatry appointments you are referred to.
- Know who to contact, and how quickly, if you spot a new problem.
- Easy-to-remove shoes and socks for the appointment
- The footwear you wear most, to be checked
- A note of any numbness, pain, cuts or colour changes
- Record of previous foot ulcers, amputation or dialysis
- Your medicines list and recent diabetes results
- Clear instructions on when and how to seek urgent help
⚠ Get urgent help if…
- A new ulcer, open sore or wound on the foot that is not healing
- Redness, heat, swelling, throbbing or pus, which can mean infection
- A foot or toe that turns blue, black, pale or cold
- Spreading redness, fever or feeling generally unwell with a foot wound, which needs urgent same-day help
- Sudden severe foot pain, or a hot swollen foot with no obvious injury (possible Charcot foot)
- Numbness, tingling or burning that is new or getting worse
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A low-risk result means no current signs of nerve or circulation problems, but it does not promise your feet will stay that way, so the yearly check and daily self-care still matter. A moderate or high-risk result means you need extra care and usually referral to a foot protection service; it is a prompt for action, not a cause for panic.
The check is a snapshot in time. It cannot predict exactly when a problem will appear, and it does not replace looking at your own feet between appointments. Its value is in catching reduced feeling or circulation early, when prevention is most effective.
Risk can change, so the check is repeated at least yearly, or more often if you are higher risk. A reassuring result is only valid for now; new nerve or circulation damage can develop, especially if blood sugar control slips, which is why regular checks and daily self-checks both matter.
Related tests, treatments or support
The foot check is usually part of your wider annual diabetes review, which includes blood sugar (HbA1c), blood pressure, cholesterol, kidney function, eye screening and weight. Looking after these together is the best way to protect your feet.
Follow-up & long-term care
If your check is normal you will usually be seen again in a year. If you are at moderate or high risk, you should be referred to a foot protection service and given a clear plan and contact route for any new problem. Active foot problems need urgent referral.
- Daily self-checks of both feet, including the soles and between the toes
- Well-fitting footwear and no barefoot walking
- Careful nail and skin care, with podiatry support if advised
- Good control of blood sugar, blood pressure and cholesterol, and stopping smoking
- Attending all foot protection or podiatry appointments
- Seeking help quickly for any new wound, colour change or swelling
Repeat, follow-on and what comes next
- Risk level can change, so the check is repeated at least yearly and more often if you are higher risk.
- A borderline or uncertain result may prompt an earlier repeat or podiatry review.
- Findings between checks (by you or a clinician) can change your risk level at any time.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clearly stated risk level with tailored foot-care advice.
- A named contact route and clear, fast escalation plan for new problems.
- Prompt referral to a foot protection or multidisciplinary foot team when needed.
- Joined-up care that also addresses blood sugar, blood pressure, cholesterol and smoking.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the check is part of a wider private diabetes review or a standalone podiatry appointment
- Whether a podiatrist or other professional carries it out
- Any extra circulation tests (such as Doppler) included
- Follow-up podiatry or foot protection appointments
- Provision of advice, dressings or specialist footwear if needed
- Frequency of checks if you are at higher risk
- Who carries out the check and how long it lasts
- Whether feeling and circulation testing are both included
- Whether any circulation tests (Doppler) cost extra
- Whether a follow-up or referral is included
- What happens, and what it costs, if a problem is found
- How urgent problems between appointments are handled
On the NHS? The diabetic foot check is offered free on the NHS at least once a year for everyone with diabetes; private podiatry is an option for extra care but the annual screen is part of standard NHS diabetes care.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told your risk level or what it means.
- A check that does not remove dressings or properly test feeling, giving false reassurance.
- No clear advice on when and how to seek urgent help between checks.
- No referral arranged when moderate or high risk is found.
Marketing red flags
- Promising to 'cure' diabetic neuropathy or restore lost feeling.
- Selling expensive devices or insoles as a substitute for proper assessment and care.
- Implying a single check removes the need for daily self-care.
- Downplaying the urgency of an active foot problem.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What is my foot risk level, and what does it mean for me?
- Was the feeling in my feet tested properly, and were my pulses checked?
- Should I be referred to a foot protection service or podiatrist?
- What exactly should I look for between checks, and how often?
- Who do I contact, and how quickly, if I find a new wound or colour change?
- What footwear and foot-care routine would you recommend for me?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Why do I need a foot check if my feet feel fine?
What is the monofilament test?
What do the risk levels mean?
How often should I have a foot check?
Is the foot check free on the NHS?
What should I do if I find a problem between checks?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE NG19 — Diabetic foot problems: prevention and management Diabetes UK — Your annual diabetes foot check Diabetes UK — Diabetes and feet Amputation-free survival in people at high risk of foot ulceration (national study) — PMC Diabetes: foot ulcers and amputations — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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