Diabetic foot is one of the more serious complications of diabetes mellitus, and although it has received sufficient attention, its high rate of disability and death is still a very difficult disease to treat worldwide. According to foreign statistics, the incidence of diabetic foot ulcers is now 2.7%/year, with a prevalence rate of 5-10% and an amputation rate of 1-7% in the type 2 diabetic population. Every 30 seconds, someone in the world has an amputation due to diabetes. In one study, a total mortality rate of 44.3% and an amputation rate of 74.1% were found in 115 patients 7 years after the diagnosis of foot ulcers. Another observation found that half of the patients with one amputation had lesions in the other lower limb 18-36 months later. There is little information on this in China, but amputations are also more common. Diabetic foot not only has a high prevalence and mortality rate, but its medical costs are even more prominent. Data from the United States show that outpatient single foot ulcers cost $28,000 over 2 years, hospitalization $16,000, minor amputations $25,000, and major amputations $32,000. Diabetic foot injuries are complex and can be caused by diabetic neuropathy, tissue structural changes, infection susceptibility and ischemia. However, they are usually the result of a combination of factors, and these injuries are difficult to treat. Firstly, patients are not aware or simply unaware of them, and secondly, physicians are in most cases unfamiliar with the clinical presentation of DF and do not know that it is a multidisciplinary knowledge and a combination of multiple factors that need to be applied to accomplish treatment. So these injuries are continuously threatened by invasive infections and these very common complications do not necessarily show the common reactions to infections. For example, fever, WBC, ESR, and elevated CRP. In the early stages of infection invasion, there can also be no typical symptoms common to local infections, such as redness, swelling, heat, and pain. Because of these conditions, infections caused by ulcers can spread insidiously, leading to tissue necrosis that may quickly damage the foot. All patients should receive personal education after the diagnosis of diabetes. A key component is self-monitoring and reporting changes in the foot on a daily basis. Others should help if vision is poor or if changes in the foot cannot be seen. All people with diabetes should have their feet checked annually to determine if there are risk factors such as foot ulcers. Once risk factors are identified, patients should receive standard treatment under medical supervision, including control of foot wear. Common risk factors for diabetic foot: Hyperglycemia Inability to care for oneself Poor vision Renal disease Advanced age Obesity Restricted mobility Mental illness Living alone Low social status Local risk factors: Peripheral neuropathy: Sensory-motor nerves Abnormal gait Joint inflexibility Arteriosclerosis: Diminished dorsalis pedis artery pulsation Intermittent claudication Vascular surgery Early onset ulcers Previous amputations Foot deformities Charcot ‘s joint Hard callus Toenail deformity Local paralysis Oedema How to manage diabetic foot ulcers 1. remove the cause 2. intensify observation and treatment 3. braking 4. treat edema and pain relief 5. control blood sugar 6. quit smoking 7. debridement 8. antibiotics and anti-infection Chinese medical understanding Diabetic extremity gangrene “blood paralysis Deglutition” Liver and kidney yin deficiency, deficiency of Ying and Wei, “the large veins are empty and develop into pulse paralysis” Blood stasis, heat toxicity, phlegm and dampness Benefiting Qi, nourishing Yin, activating blood circulation, clearing heat and drying dampness