People with diabetes often have reduced sensitivity in the soles of their feet. This creates a risk that minor injuries and blisters go unnoticed, allowing ulcers to develop quickly, which can lead to amputations. This serious progression can usually be prevented if the key preventive measures are known and followed.

1. Examine your feet daily – foot inspection
   Use a mirror for areas that are hard to see, or ask a family member to check your feet. Pay particular attention to:

• Pressure points – show these to your doctor or your orthopaedic shoemaker
• Blisters – consult a doctor immediately
• Calluses – show these to your doctor or a podiatrist
• Calluses with dark spots (pre-ulcerative lesions) – consult a doctor immediately
• Corns – show these to your doctor or a podiatrist
• Redness, swelling – consult a doctor immediately
• Ingrown toenails – show these to your doctor or a podiatrist
• Any kind of skin injury – consult a doctor immediately
• Whitish, cracked skin between the toes may indicate athlete’s foot. Discolored (yellowish or whitish) or thickened toenails may indicate a fungal nail infection. Speak to your doctor at your next appointment about treatment for fungal infections.

2. Practice foot-healthy habits in everyday life

• Do not walk barefoot or only in socks, as reduced sensitivity may prevent you from noticing small injuries
• Never expose your feet to excessive heat, as reduced temperature sensation can easily lead to burns
• Avoid walking barefoot on sandy beaches
• Do not use hot water bottles, especially metal ones. Do not use electric blankets. Tile stoves or open fireplaces can also cause burns—avoid close proximity to open heat sources
• Avoid excessive sun exposure to your feet

3. Wear the insoles or shoes prescribed or recommended by your doctor

• It is not helpful to have only one pair of insoles or special shoes if they are not used regularly. It is recommended to have at least two pairs for outdoor use and one pair of indoor shoes. All pairs should be fitted by an orthopaedic shoemaker in consultation with your doctor. Change shoes several times a day
• If you already have an ulcer on your foot, it must be completely offloaded. Even a few steps on an ulcer can undo weeks of healing**