There are more than 100 million people in the world suffering from diabetes. The prevalence of diabetes in China is growing extremely fast. 10 years ago, there were only about 30 million diabetics in the world, but now, according to incomplete statistics, the number of diabetics in China alone has reached nearly 100 million, surpassing the total number of diabetics in Europe and the United States, ranking first in the world. In Western countries, 5% to 10% of diabetic patients have foot ulcers of varying degrees, and 1% of diabetic patients have their limbs amputated. In China, the incidence of diabetes and its foot complications may be higher and more harmful due to the lack of awareness of the disease. Severe diabetic foot ulcers can cause a serious decline in quality of life, high treatment costs, long treatment time, and once amputated, lead to patient disability. At the same time, diabetic foot ulcers are easy to occur, change rapidly and are difficult to heal, making them a difficult problem to treat clinically. Zhou Tao, Department of Peripheral Vascular Medicine, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine The diabetic foot is an infection, ulcer formation and/or necrosis of the lower limbs of diabetic patients due to combined neuropathy and various degrees of vascular disease. According to the International Diabetes Federation, 70% of amputations occur in diabetic patients, and someone loses a leg to diabetes every 30 seconds worldwide. More unfortunately, 85% of amputations due to diabetes can be prevented and avoided. The diabetic foot is not a generalized concept, but is divided into three types. Each type has a different treatment plan for diabetic foot, and if confused, it can easily lead to delay and serious consequences. The first type is the neuropathic type. This type of foot disease is clinically manifested by numbness and loss of sensation in the foot. Diabetic neuropathy can involve the sensory nerve, motor nerve and autonomic nerve, and the sensory neuropathy is mostly in the form of glove-like distribution of sensory abnormalities or even sensory loss, so that the patient’s sense of protection against temperature, pain, pressure, etc. is weakened or lost, and in the presence of external factors such as burns, foreign bodies, trauma, etc., foot ulcers will occur in the absence of protective sensation. The second type is the arterial ischemic type. This type of diabetic foot is extremely easy to be misdiagnosed and leads to the most serious consequences. Clinically, due to the long-term impact of high blood sugar in diabetic patients, the blood vessels in the lower extremities are hardened, the walls of the blood vessels are thickened, and the elasticity is reduced, so that blood clots can easily form and collect into plaques, resulting in occlusion of the blood vessels in the lower extremities, thus causing tissue lesions in the lower extremities. The “foot” is the farthest from the heart, and the ischemia is the most serious, resulting in edema, blackening, decay, necrosis, and gangrene. The third type is the mixed type, in which neuropathy and arterial ischemia coexist. So, how do you deal with the different types of diabetic foot? For the first type, the neuropathy type. It is necessary to strictly control blood sugar under the guidance of a doctor, and at the same time take active protective measures such as checking the feet regularly, paying attention to loose shoes and socks, avoiding local pressure and trauma, and preventing foot odor to prevent ulcer formation and infection for the neuropathy type. The second and third types of diabetic foot (i.e., diabetic foot with arterial ischemia) are treated early with good results. A simple way to initially determine the presence of arterial vascular occlusion is by examination of the dorsalis pedis and posterior tibial pulses. In many patients, the early symptoms of walking for a certain distance and then having to stop and rest, and then being able to walk the same distance for a few minutes, are called “intermittent claudication”. This is the time to seek medical attention from a specialist in vascular surgery. For patients who have developed diabetic foot, all therapeutic drugs, oral or intravenous, are ultimately delivered to the lesion through arterial blood. If there is vascular occlusion or stenosis, the medication cannot reach the lesion and the treatment will be ineffective or poor. Therefore, the key to the treatment of diabetic foot is to use vascular surgery to unblock the diseased blood vessels as much as possible on the basis of Chinese and Western medicine treatment.