My daughter asked me this questions just the other day on our way to an event. Two reasons why it is important for the diabetics to have a yearly foot exam: First, circulation issues, and second, neuropathy or impaired sensation in the toes or feet. Let me explain. Diabetes affects both the small and large blood vessels in the body by increasing the thickness in the vessel wall which in turn slows down or occludes the blood flow to the feet. Without adequate blood flow, the tissues in the feet lack proteins, nutrients, and oxygen which leads to damage or necrosis (gangrene) therefore resulting in loss of a digit or limb. Diabetes over time can also affects sensation/ what we feel, star