How often should a patient undergo diabetes foot screening?

The NICE guideline states that:

‘Children and adults with diabetes should have their risk of developing a diabetic foot problem assessed’.

There is limited evidence to support the frequency of screening; however the NICE guideline group recommends the following:

‘For adults with diabetes assess their risk of developing diabetic foot problem at the following times:

  • When diabetes is diagnosed and at least annually thereafter
  • If any foot problems arise
  • On any admission to hospital and if there is any change in their status while they are in hospital

For children with diabetes who are under 12 years give them and their family members or carers (as appropriate) basic foot care advice.

For young people with diabetes who are 12-17 years the paediatric care team or the transitional care team should assess the young person’s feet as part of their annual assessment and provide information about foot care.’


Every patient should be informed of their risk category and have that risk explained to them in accordance with the Diabetic Foot Risk Stratification and Triage Chart. Every patient should be given verbal and written information regarding their risk status.

It is recommended that all Low risk patients are educated in self management, this can be achieved through individual or group educational programmes. Patients of ModerateHigh and Active foot disease will receive a treatment and management plan by a podiatrist and will receive updated education at each visit.

It is hoped that following the appropriate risk categorisation with the subsequent introduction of a treatment/management plan that this can minimize and/or help prevent foot problems.

Education leaflets

The leaflets above can be downloaded below and from the Links and Resources page.



High risk

Diabetic foot risk stratification and triage – high risk

Diabetic foot risk stratification and triage - high risk

Moderate risk

Diabetic foot risk stratification and triage – moderate risk

Diabetic foot risk stratification and triage - moderate risk

Low risk

Diabetic foot risk stratification and triage – low risk

Diabetic foot risk stratification and triage - low risk

Who should carry out foot screening?

Foot screening may be carried out by any healthcare professional/worker involved in the care of a patient with diabetes.

It is not important who undertakes the screening process as long as the individual carrying this out has the competence and training to do so and is aware of what action to take depending on the results and the patient’s risk status. This competence can be gained by taking the module test at the end of these modules.

03: The purpose of foot screening (NHS England)


Diabetic foot screening is the cornerstone of good diabetic foot care.

The purpose of diabetic foot screening is to carry out a quick, simple, and evidence based screening to determine at what risk a patient is of developing a diabetic foot ulcer, which may lead to an amputation. The patient should be made aware of their foot risk status and have an appropriate treatment/management plan agreed with the patient and implemented if/when required.

Open diary page

The NICE: Clinical Guideline 19: Diabetic foot problems: prevention and management is produced in the UK by the National Institute of Health and Care Excellence to guide clinicians on the most up to date, and evidence based practice. This guideline will mainly be of interest to all healthcare professionals involved in the care of people with diabetes. The target users are, however, much broader than this, and include people with diabetes, their carers and those who interact with people with diabetes outside of the NHS. It will also be of interest to those planning the delivery of services in England and beyond.