 Hi, I'm Dr. Praveen Nayak, Chief Consultant of Department of Podiatric Surgery, KNC Mangalore. Diabetes is quite a common condition, it's about 8% of population and 15% of these come across with food problems. Diabetic food, if you look at the diabetic food itself, diabetes on a long term affects the blood vessels and nerves. Coming to the blood vessels, they are the parts of the cardiovascular system which heart pumps the blood and the blood is taken to various parts of the body. This takes the nutrition what is required. For example, if it is food, the skin, the bones, the muscles for its life, it needs nutrition which is taken by the blood vessels. Whereas the nervous system is a little different. It is connected to the brain with so many wires. It does two functions, sensory and motor. All the sensation, the touch, pressure, pain, temperature, all the various kinds of sensation from the feet are taken appreciated in the brain taken via these nerves. That is the sensory part of the nervous system. At the same time, there is a motor part of the nervous system which helps in movement of the toes or ankle or any other part of the foot or any part of the body for that matter. Now as I told you, there are two systems cardiovascular and nervous system. Nervous system is commonly affected in diabetic food. So what happens is you lose the sensation of the feet and you lose important movements of the feet. So this is the main problem. So what happens is injury goes unnoticed. Once the injury goes unnoticed, it will not be identified at the time of injury and by the time the patient realizes the injury, it is almost a week or a 10 days and it would have already complicated. So what we have seen earlier is, it is the loss of sensation which has led to a major complication. A decreased blood supply will lead to vulnerable foot, diminished nutrition and a vulnerable foot for injury and further complications. So how do we manage this? There are 10 commandments of diabetic foot care. The most important three, one should always, if you are diabetic, you should always remember is examine your foot every night before sleeping. Look for any injury. If any injury is there, treatment has to be started immediately. Do not walk barefoot. The prevention is the best way. So as the foot doesn't have any sensation, if you wear the footwear all the time, once you are getting out of the bed, it should be in the footwear. So chances of injury becomes much lesser. The second one as I mentioned earlier is examine the foot every night to see if any injury has occurred in spite of wearing the footwear. And the third important thing is examine your footwear every morning before you wear the footwear. If it is shoe, you have to put your hand inside the shoe and see if any object is there inside the shoe or you have to also examine the outer surface, outsole of the shoe and insole of the footwear to confirm that there is no foreign object is there in the footwear. These are the three most important things. Other than these, there are a few other important things. For example, do not give hot water bath to the foot. The many people have a habit of dipping their feet into the hot water. Since the foot doesn't have a sensation, all sensations I mentioned to you touch pressure, pain and temperature. They don't have a hot sensation. So they can even dip their feet into the boiling hot water without any pain. So one should avoid dipping the feet into the hot water. Do not give hot water bath. Do not give vigorous oil massage and do not apply any plaster. If you have a small wound or a nail injury, some injuries there, do not apply plaster onto the skin directly because as you remove the plaster, you may create another wound that becomes even more complicated, especially if it is a decreased blood supply or an ischemic foot. And cut the nails regularly, cut trim them square. I feel it's very important for a common man to understand that vessels take the nutrition and nerves give the input from the feet or various parts of the body to the brain. These inputs are very, very important. They are protective. So losing this protective sensation is the most common complication and the most common cause of a diabetic foot ulcer which can be easily prevented by taking good care of the feet.