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The major goal here is to prevent amputation. The ADA position statement identifies the following factors as significantly increasing risk of amputation:

1. Peripheral neuropathy with loss of sensation     
2. Bony deformity of the foot
3. Peripheral vascular disease
4. Severe nail problems
5. A history of ulcers or amputation

Foot care is one of the most demanding areas for you to cover in your history and physical exam. Ask the patient about previous foot problems and any recent foot trauma.

Ensure that the patient is performing daily foot care, including visual inspection and washing and drying (including between the toes). Also be sure the patient is avoiding heating pads or soaking his feet in hot water if s/he has decreased feeling. Many people with diabetes have dry skin, due to decreased sweating as a type of neuropathy or fungal infection of the skin. Individuals with dryness should moisturize their feet daily, preferably with a salve, such as Eucerin, Bagbalm, or Vaseline, which are generally more effective than a lotion, such as Vaseline Intensive Care.