How Often Should Someone With Diabetes Have Their Feet Checked?
Quick answer: Everyone with diabetes should have a full foot check by a podiatrist at least once a year. If the check finds you are at higher risk, you will need checks more often: every 3 to 6 months at moderate risk, and every 1 to 2 months at high risk. Any new wound, swelling, redness or colour change should be seen within one working day.
About 1 in 7 adults in Bermuda lives with diabetes (13.4% of adults aged 20 to 79, according to the IDF Diabetes Atlas). Foot problems are one of the most common and most preventable complications, so regular checks matter. Here is what the guidance says, what happens at a check, and how to know which group you are in.
How often do I need a diabetic foot check?
How often depends on your risk level, which your podiatrist works out at your first full assessment. The UK's NICE guideline NG19, which we follow at Atlantic Podiatry, sets these intervals:
| Risk level | What it usually means | How often to be checked |
|---|---|---|
| Low risk | Normal feeling and circulation, no other risk factors | Once a year |
| Moderate risk | One risk factor, such as reduced feeling, poor circulation or a foot deformity | Every 3 to 6 months |
| High risk | Two or more risk factors, or a previous ulcer or amputation, or on kidney dialysis | Every 1 to 2 months |
| Active problem | An ulcer, spreading infection, a hot swollen foot or colour change | Seen urgently, within 1 working day |
Your risk level can change over time, so it is reassessed at every check.
Why do people with diabetes need their feet checked at all?
Raised blood sugar over time can damage the nerves in the feet (peripheral neuropathy) and narrow the blood vessels that supply them. Together these mean you may not feel a blister, cut or pressure point, and the skin may heal more slowly when it is damaged. A small problem that goes unnoticed can turn into an ulcer or infection.
A regular check finds these changes early, often years before they cause trouble, so they can be managed with simple steps like better footwear, insoles or nail and skin care.
What happens at a diabetic foot check?
A full diabetic foot assessment at our Hamilton clinic usually takes 30 to 45 minutes and is painless. Your podiatrist will:
- Look at your skin and nails for hard skin, cracks, corns, colour change, infection or early signs of pressure damage.
- Test feeling in several places on each foot, usually with a thin nylon filament (a monofilament) and a tuning fork.
- Check circulation by feeling the foot pulses and, if needed, using a hand-held Doppler to listen to blood flow.
- Look at foot shape and footwear for deformities such as bunions or clawed toes and for shoes that rub.
- Give you your risk level, explain what it means and agree when your next check should be.
Diabetes UK has a helpful patient guide to what to expect at your annual foot check.
Is a check by my GP or nurse enough?
A quick look by your doctor or diabetes nurse is useful, but it is not the same as a full podiatry assessment. A podiatrist specialises in the lower limb and can treat what they find on the same day: safely reducing hard skin and corns, cutting thickened nails, offloading pressure areas and prescribing insoles. If you are at moderate or high risk, ongoing care from a podiatrist is recommended.
What should I do between checks?
Most diabetic foot problems are caught by the patient first. Between appointments:
- Look at both feet every day, including between the toes and the soles (use a mirror or ask someone to help).
- Wash and dry your feet carefully and moisturise the skin, but not between the toes.
- Avoid walking barefoot, including on the beach and around the pool. Hot sand and coral can cause injuries you may not feel.
- Check inside your shoes before putting them on, and wear well-fitting footwear with socks.
- Do not use corn plasters or medicated pads, which can burn the skin.
- Keep your blood sugar, blood pressure and cholesterol as well controlled as possible, and stop smoking if you smoke.
When should I get my feet seen urgently?
Contact a podiatrist or your doctor the same day if you notice any of these:
- A break in the skin, blister or wound that is not healing
- Redness, warmth or swelling, especially if one foot is hotter than the other
- A change in colour of the skin or toes (pale, blue, purple or black)
- Pus, a bad smell or new pain
- Fever or feeling unwell alongside any foot problem
If you feel very unwell, go to the Emergency Department at King Edward VII Memorial Hospital. Learn more about our wound care and high-risk foot services.
Frequently asked questions
Do I need a referral for a diabetic foot check in Bermuda?
No. You can book a diabetic foot assessment with Atlantic Podiatry directly. Your doctor can also refer you if you prefer.
Does a diabetic foot check hurt?
No. The tests involve light touch, a gentle vibration and feeling your pulses. Nothing is sharp or uncomfortable.
I have type 2 diabetes and my feet feel fine. Do I still need a check?
Yes. Nerve and circulation changes often cause no symptoms at first, which is exactly why a yearly check is recommended for everyone with diabetes.
Can I have my check at home?
Yes. If getting to the clinic is difficult, we offer house calls and care home visits across Bermuda.
Book your diabetic foot check in Hamilton
Atlantic Podiatry is on the 5th floor of Weldon House, 7 Victoria Street, Hamilton. Book online or call (441) 533-2508.
This article is general information and is not a substitute for a personal assessment. If you are worried about your feet, please book an appointment or speak to your doctor.
Written by Matthew Francis, Clinical Director and Podiatrist at Atlantic Podiatry (MSc Wound Healing and Tissue Repair, Cardiff University).
