People with diabetes are prone to foot problems because complications of the disease can damage their blood vessels and nerves. This, in turn, may make you less able to sense injury or pressure on the foot. A foot injury may go unnoticed until severe infection develops.

Diabetes also alters the immune system, thus decreasing the body's ability to fight infection. Small infections can rapidly progress to death of the skin and other tissues (necrosis), which may require amputation of the affected limb to save the patient's life. Foot problems can be prevented in part with improved blood sugar control.

If you have diabetes, you are at higher risk for developing foot problems if you:

• have had diabetes more than 10 years
• are male
• have poor glucose control
• have eye, kidney, or heart complications.

All diabetics should get regular foot exams -- at least twice yearly -- by their health care provider and should learn whether they have nerve damage.

TIPS ON SHOES AND SOCKS

• Wear shoes at all times to protect your feet from injury. Otherwise, if you have poor vision and less ability to detect pain, you may not notice minor cuts or bumps.
• Wear comfortable, well-fitting shoes. Never buy shoes that do not fit properly, expecting the shoes to stretch with time. Nerve damage may prevent you from being able to sense pressure from improperly fitting shoes.
• Check the inside of your shoes for rough areas or torn pieces that can cause irritation.
• Change your shoes after 5 hours of wearing during the day to alternate pressure points.
• Avoid wearing thong sandals or stockings with seams that can cause pressure points.
• Wear clean dry socks or non-binding panty hose every day. Socks may provide an additional layer of protection between the shoe and your foot.
• Wear socks to bed if your feet are cold. In cold weather, wear warm socks and limit your exposure to the cold to prevent frostbite.