Callus: A small area of skin, that becomes thick and hard from rubbing or pressure.

Gangrene: Occasionally a bad infection never heals. The infection might cause gangrene. In gangrene there is death of body tissue. The area becomes black and smelly. It is most often caused by loss of blood flow, especially in the legs and feet.

Ulcer: A break in the skin; a deep sore. People with diabetes may get ulcers from minor scrapes on the feet or legs, from cuts that heal slowly or from the rubbing of shoes that do not fit well.

Athlete’s foot. It is caused by fungal infection. There is redness and cracking of the skin between the toes. If blood glucose levels are high the infection bets worse and can spread to the toenails. The toes become thick, yellow and hard to cut.

Dry and cracked skin. This condition occurs because of damage to nerves and reduced blood supply. These cracks can get infected.

Hammertoes form when a foot muscle gets weak due to nerve damage. The tendons in the foot become shorter. Therefore, the toes curl under the feet. Sores may develop on the bottoms of the feet and on the tops of the toes.
Hammertoes can cause problems with walking.

Diabetics account for the second largest group of people undergoing lower limb amputations (after accidents) in our country. Usually the problem starts with a small wound caused by the footwear or an injury secondary to walking barefoot. If not properly cared for, this harmless, small wound can lead to severe infection, gangrene or a non-healing ulcer. These conditions may require amputation of the affected part.

Foot problems are the commonest reason for repeated hospital admissions and prolonged hospitalisation in diabetics. A diabetic patient, who has any of the following conditions, has high chances of getting foot problems:

• Persons who smoke,
• Persons who have diabetic eve disease,
• Persons who have nerve problems,
• Persons who do not examine the feet daily.

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