Vascular and Endovascular Sciences

Vice President:
Vascular Access Society of India

Editorial Board:
Annals of Vascular Surgery

Asian Society of Vascular Surgery

Medanta Hospital, Gurugram, Haryana 122001


Dr. Tarun Grover
Dr. Tarun Grover
Peripheral Vascular & Endovascular Sciences

Diabetic Foot

Diabetes & foot

Diabetes is a chronic condition that can cause a number of serious complications. Problems with the feet are one of the most common. The purpose of this brochure is to provide information on what you need to know about feet and diabetes and what sort of help you should seek.


Not all people with diabetes develop foot problems. In many cases serious problems can be prevented by an understanding of what can happen to feet and how to take care of them.

What are the types of diabetic foot problems?

People with diabetes are more prone to infection. They can also develop neuropathy (damaged nerves) or peripheral vascular disease (blocked arteries) of the legs and either can lead to foot ulceration. Infection and foot ulceration, alone or in combination, often lead to amputation.

Can diabetic foot problems be prevented?

If diabetes is well controlled it should be possible to avoid these foot problems. However, as it is not always possible to achieve good diabetic control and as severe neuropathy and peripheral vascular disease cannot be easily reversed, many people with diabetes are at risk of developing foot problems. Therefore it is important to know how best to minimize the risk of foot problems and how best to treat them.

What are the steps that can be taken to prevent or treat foot problems?

Good diabetic control is always helpful. However, by itself, it is often not enough. For people with diabetes who have not yet developed active infection or ulceration, the important thing is to grade the degree of risk and have appropriate foot care education to minimize the risk of developing active foot problems.

For people already with infection or ulceration, the important thing is to urgently treat the infection and heal the ulcer.

Foot Examination

Who is at risk of developing a diabetic feet ulcer?

Ina sense every person with diabetes has increased risk of developing foot ulceration and needs to take precautions to prevent it from occurring. However, some people have very low risk and some people have very high risk.

Grading the risk helps the individuals and the health professionals to take appropriate measures without being too relaxed or too strict. This is not only good for the individuals. it also helps to direct valuable health care resources to people who need it. Patients at low risk only need general advice. Patients at high risk need detailed, specific and practical foot care instruction.

The overall risk of an individual developing a diabetic foot ulcer is determined by a combination of factors. In general, the risk is higher if:

Foot care

Foot care for those at high risk of developing a foot ulcer

Every person with diabetes needs to be careful about the feet However, if the risk is high because of neuropathy or peripheral vascular disease or other factors (see the section on Foot Examination), then particular attention is needed. This section is specifically for this group of individuals.

Daily foot can should include:

Look at your feet - every day. Look at the top and bottom of your foot Look and feel in between your toes and around the heel area.

What to look for:

If you are unable to see your feet use a mirror or ask someone to help you if you cannot manage to examine your own feet.

Check for Cams and Calluses (hardened skin)

Corns and calluses can be a problem. They cause pressure and can lead to ulceration. Never Vim or cut a corn yourself. Do not use a can pad, they burn the skin and you may develop an ulcer from this. Using a pumice stone can also be dangerous, as you cannot feel your feet. The only safe way to treat a corn or callus is to see a podiatrist.

Wash your feet every day using warm water and mild soap. Check the water with your elbow first to make sure it is not too hot. Cry your feet using a light colored towel, especially between the toes. Look at the towel to make sure there is no blood or pus on it. If you can see any blood or pus tell your doctor immediately.

It is important to dry between your toes well. If the skin between your toes becomes white and soggy (macerated) apply some methylated spirits using a cotton bud. If the problem doesn't go away in a couple of days, see your doctor.

Rub cream into your feet to stop them getting dry and cracked. Do not put cream between the toes. Use the cream twice a day if your feet are very dry. There are special creams for very dry and cracked heels containing urea. A cream in a pump bottle is preferable as it rubs in more easily.

General Foot care should include:

Nail care: Do not cut your nails too short. Cut your nails straight across. Always check your nails for sharp edges. To smooth sharp edges use a nail file. If you are unable to cut your nails, see a podiatrist.

Removal of callus on a regular basis. Again this is preferably done by a podiatrist in this group of high risk individuals.

Soaking the feet is not recommended as daily foot care. However if the feet are soaked for any reason it should be no longer than 2-3 minutes as this makes the skin too soft and fragile.

Note: Foot Spas can be dangerous for people with diabetes, especially those with neuropathy or vascular disease. Speak with your health care provider prior to use.

Bare feet are not only at high, of injury, but the pressure under the foot is increased when walking without the cushioning of shoes to protect the feet. Wear thick socks with well cushioned, closed shoes which are large enough to fit the foot and sock.

Other than personal care, following, are some measures & tests to study blood flow and take care of feet

Handheld doppler examination

Biomechanical Exam- 'Foot Scan'

Principles of diabetic foot ulcer management

Treatment of poor blood flow

Infection Control

It is taken care in order to prevent Sepsis that is an infection all over the body which spreads due to infection in blood stream.

Ultrasonic assisted wound treatment (UAW)

What are the benefits from the treatment?

Treatment for diabetes foot care improves the quality of life and prevents the occurrence of gangrene (black toes and foot, infection in toes) and ulcers.

What is the expected outcome of the surgery?

Your discharge depends on the procedure you have undergone, which will be discussed by your doctor. You may resume to your activities depending upon your physical strength and the evaluation done the healthcare expert.