The foot is a complex target organ for the multisystemic disease of diabetes. The combination of peripheral neuropathy and peripheral vascular disease with excessive mechanical stress in diabetic patients can cause destruction and deformity formation in the soft tissues and osteoarticular system of the foot, which in turn can lead to a range of foot problems, from mild neurological symptoms to severe ulcers, infections, vascular disease, Charcot arthropathy and neuropathic fractures. If aggressive treatment does not adequately address the symptoms and complications that arise in the lower extremity, the consequences can be catastrophic. Therefore, early prevention and treatment of foot problems in diabetic patients will be of great importance. A thorough physical examination of both lower limbs below the knee should be performed. This should be done at least once a year, and more frequently in high-risk groups. The following issues should be observed and recorded: gait abnormalities, wear and tear of shoes and the presence of foreign objects protruding into the shoe, vascular pulsations, hair growth, refilling of skin and capillaries, observation of deformities and tissue destruction in the foot and heel, location and size of ulcers, and the presence of edema or inflammation. The stability of the joints and the strength of the muscles should also be checked. 2.Comprehensive neurological examination Reflex, motor and sensory function examination. Qualitative sensory examination, such as light touch, two-point discrimination, pins and needles, and proprioception. Quantitative sensory examination, most often using Semmes-Weinstein nylon monofilament for pressure examination. 3. Vascular examination The most commonly used non-invasive examination is arterial Doppler ultrasound. The data are expressed by absolute pressure or ankle-brachial index. An ankle-brachial index of 0.45 is considered to be the minimum value for a healable wound after amputation. An absolute toe vascular pressure of 40 mmHg is the minimum value for wound healing criteria. Note that patients with atherosclerotic disease may have falsely elevated pressure values. Other vascular tests include measurement of skin perfusion pressure and transcutaneous partial pressure of oxygen. The former is a test to determine the minimum pressure required to block the refill of the skin after compression. The latter can also be used to determine the potential for healing after amputation. A pressure of less than 20 mmHg is associated with a high risk of wound infection, while a pressure above 30 mmHg indicates adequate healing potential. Blood glucose control is very important in the care of the diabetic foot. There is a high risk of ulceration if the diabetic metabolism is poorly controlled. If hemoglobin A1c (glycosylated hemoglobin) is elevated, the ulcer healing time is prolonged and the likelihood of recurrence is increased. Changes in these indicators predict patient compliance and optimal healing. In addition, serum total protein, serum albumin, and total lymphocyte count should be checked. The minimum values favoring tissue healing are: serum total protein concentration above 6.2 g/dl; serum albumin level above 3.5 g/dl; and total lymphocyte count above 1500/mm3. 5. Imaging Plain x-ray is the first-line diagnostic test used to evaluate stress fractures, fractures, osteolysis/bone destruction, dislocations, subluxations and changes in bony structures of the foot and ankle; CT is used to evaluate details and alterations in cortical bone with better results, such as assessing healing of postoperative fractures or fusions. In addition, CT can be used to evaluate soft tissue disorders such as abscesses; MRI is very sensitive to soft and bony tissue changes from a variety of causes, such as stress fractures, abscesses, osteomyelitis, or neuropathic arthropathy. However, there are difficulties in distinguishing between Charcot joint and osteomyelitis. Because both lesions have bone marrow edema and erosion-like changes.