People with diabetes often have foot problems. That's mostly because diabetes increases the risk of two conditions, peripheral vascular disease and peripheral neuropathy. Both of these make the feet more vulnerable to injury. Peripheral vascular disease reduces blood flow to the legs and feet. Peripheral neuropathy is a type of nerve damage. It can cause feet to lose feeling and go numb.

Foot problems may include ulcers that heal slowly or not at all. In extreme cases, an infected ulcer must be treated by amputating part of the foot. With careful preventive care, amputation is not necessary for the large majority of foot ulcers.

In your regular physical exams, your doctor will test for numbness. You also can monitor your feet for this change. If you do not have normal feeling in your feet, you should check them frequently. Look for signs that they may be rubbed or pressed by poorly fitting shoes.

One obvious sign of rubbing or pressure is a buildup of thickened skin, called a callus. It may seem like a callus would protect your foot from pressure. Actually, it makes your foot more vulnerable. Soft underlying tissues may be injured by the pressure of a callus. A blood blister can form beneath the thick skin. Irritation from the blood blister can wear away the center of your callus from the inside out. This creates a hole. It's the way many ulcers get their start.

Wounds such as ulcers heal slowly if they do not get enough blood. Cold feet can be one sign of poor circulation from narrowed arteries. A more reliable clue to artery trouble is a pain in the legs or buttocks that occurs when you are walking. It will stop soon after you begin to rest. This symptom is called intermittent claudication.

Exercise is a good treatment for poor blood flow. With regular exercise, you should be able to walk longer before you feel pain in your legs.

Injury to your feet can come from many sources. They include:

If your feet are at risk, you need to be on guard. You can take steps to prevent injuries and prevent them from getting worse when they do occur.

If your daily foot inspection shows anything that concerns you, see your doctor or podiatrist. Causes for concern might include a new sore, an irritated spot that isn't getting better, or a break in the skin. Foot problems can be treated in several ways:

• Medicines (primarily anti-fungal drugs)
• Bed rest and elevating the feet
• Debridement (scraping away of dead tissue)
• A cast
• Special shoes
• Vascular surgery (artery surgery) or bone surgery