ADA Risk Assessment Recommendations for DPN 

Annual foot exams

• Assessment of protective sensation, foot structure, biomechanics, vascular status, and skin integrity

Visual inspection of feet with every health care visit

• Skin inspected for integrity (toes and metatarsal heads)
• Determination of erythema, warmth, or callus formation
• Identification of bony deformities
• Assessment of limitation in joint mobility
• Assessment of gait and balance disturbances

Neurological evaluation of feet

• Semmes-Weinstein 5.07 monofilament
• Tuning fork

Initial screening for peripheral arterial disease (PAD)

• History for claudication
• Assessment of pedal pulses
• Consider obtaining ankle-brachial index (ABI)