pinprick test for diabetic neuropathyPeople with diabetes are at higher risk for a variety of foot problems. Most concerning are diabetic ulcers as they can lead to amputation. For this reason, the American Diabetes Association recommends that diabetic patients have a Comprehensive Diabetic Foot Exam (CDFE) annually. 

The CDFE is a comprehensive, visually compelling exam that was developed to identify, monitor, and thus prevent complications to your feet.

The exam includes:

Testing for Sensation

Patients with diabetes often develop diabetic neuropathy which means they can't feel light touch or pressure against their feet. Being able to feel pain and other sensations are important part of the alert system in the body. Without them ulcers can develop from small stones in shoes or rubbing from poor shoes. Our office does testing of light touch using a small filament and pressure testing using a vibratory sensation device.

Lack of pain sensations can cause patients be problematic when readings of the feet; this will allow you to see and discuss any at-risk conditions and offending pressure points that may be evident.

Testing for Circulation

Without good circulation to the feet it's hard to heal from scratches, scrapes, and injuries. Your podiatrist will check the pulses in your feet to determine how well your blood is circulating to that area of your body.

Visual Inspection of Skin

Your podiatrist will check your skin for dryness, cracks, ulcers, and any problems with your nails.

Check Foot Structure

Your foot structure can cause problems with your feet by putting pressure on areas that can lead to ulcers. Your podiatrist willl check for bunions, hammertoes, flatfeet, and other foot irregularities.

Muscle Testing and Gait

It's important to identify any problems with motor skills which can alter the way you walk. The doctor will do muscle testing and watch you walk.

Checking Shoes

Your shoes are critical in protecting your feet. Your podiatrist will check your shoes to determine if they are keeping your feet healthy and recommend new shoes as needed.


The results of your CDFE will be the basis of recommended changes to help you avoid health-threatening complications related to your diabetes.

The CDFE also assesses whether you qualify to receive therapeutic shoes through Medicare. Please come to your appointment with shoes and insoles that you typically use so we can see how well they are fitting and if they are wearing properly.

Together, we will continue to help you avoid foot ulceration, infection, and even the very real possibility of amputation. Regularly scheduled evaluations of your feet and wearing appropriate shoes and inserts, combined with your daily home inspection of your feet, will always be the keys to avoiding serious foot complications.

If you have diabetes and have not done so already, it is important for you to contact our office to schedule a Comprehensive Diabetic Foot Exam at your earliest convenience.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.