Diabetic foot: strategies to prevent and treat common problems.

Neuropathy, peripheral vascular disease, limited joint mobility, and reduced resistance to infection all play a role in the development of foot pathology in diabetic patients. Once established, ulcerations and infections may provoke an irreversible cascade of events, culminating in limb loss. The best cure, therefore, is prevention. Working as a team, the primary care physician and the podiatrist can prevent problems before they occur and manage problems when they do happen. Shoes for the diabetic with neuropathy should have laces or a strap, a soft wide toe-box, and ample plantar soft tissue supplementation. When ulcers do occur, the mainstays of management are weight dispersion, debridement of devitalized tissue, and use of antibiotics where appropriate.