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NICE NG19 recommends annual foot examinations for all people with diabetes, incorporating: 10-g monofilament testing (Semmes-Weinstein monofilament) to assess protective sensation at standardised foot sites Vibration perception using a 128-Hz tuning fork at the hallux Ankle reflex examination Visual inspection for structural deformities, skin changes, and ulceration Assessment of peripheral pulses (dorsalis pedis and posterior tibial) to evaluate vascular status Foot risk stratification (low, moderate, high risk, or active diabetic foot problem) Patients reporting neuropathic symptoms should undergo comprehensive neurological examination

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