Definition of diabetic foot: a foot disorder caused by loss of sensation due to neuropathy or loss of mobility due to ischemia, combined with infection in diabetic patients. The most common consequence is chronic ulceration, and the most serious outcome is amputation. Diabetic foot lesions are the result of a complex interaction between peripheral neuropathy (including autonomic neuropathy), macrovascular disease, and poor foot hygiene. The magnitude of the role of each factor varies from person to person and may also vary by race. For example, in some Asian populations, peripheral vascular pathology may play a lesser role. It is one of the most dreaded complications of diabetes because of its consequence of leading to lower limb amputation. The chance of lower limb amputation is 15-40 times higher in diabetics compared to the general population. The risk is higher in the elderly. However, most amputations can be avoided if managed aggressively. Peripheral neuropathy with loss of pain sensation is the most common cause of foot ulcers, with poor foot hygiene being the next most common cause. This type of neuropathy and ulcers can be completely painless. Peripheral vascular disease can also cause foot ulcers, which are prone to pain. Peripheral vascular disease is the main cause of difficult healing of neuropathic ulcers, and refractory ulcers are the most common cause of eventual amputation. Neuropathic ulcers occur in areas of increased pressure, usually on the plantar surface of the foot. The most commonly reported site of occurrence is a neuropathic ulcer that occurs on the back of the toe due to ill-fitting shoes, and callus formation is also a result of this pressure. In order for the ulcer to heal, 1. local pressure needs to be reduced (removing the callus, wearing appropriate shoes, or using decompression pads) 2. blood supply should be improved, 3. infection should be actively controlled, and antibiotic treatment often needs to be continued for many weeks or months. 4. prompt debridement of infected and necrotic tissue should be emphasized. Routine examination of the sensory or dorsalis pedis artery pulsations is the most important way to detect a foot at risk for ulceration. Education on foot care for patients who are clearly at risk should be more detailed and practical than for other diabetic patients with intact sensation and circulation. There is no satisfactory treatment for painful neuropathy. Useful approaches include enhanced metabolic control and the use of simple analgesics, tricyclic antidepressants, or anticonvulsants to relieve pain. If glycemic control is very poor, foot infections and ulcers can occur in the absence of neuropathy and peripheral vascular disease due to poor foot hygiene. In such cases, in addition to tightening blood glucose control, patients should be instructed to wear shoes to reduce the chance of foot trauma. If shoes are worn, clean socks must be worn!