I. Diabetic foot epidemiology One quarter of diabetic patients have an elevated risk of foot injury due to diabetic neuropathy and vasculopathy. The annual rate of new foot lesions in diabetic patients is 3-7%. The risk of secondary ulcers rises progressively after healing of a foot injury, between 30% and 100%, depending largely on the quality of follow-up care. Similar to other types of amputations in the past, diabetic patients must be considered as a high-risk group for amputation and require very careful and planned monitoring and care. More than 20,000 diabetic patients with foot lesions eventually require amputation each year in Germany. After amputation, the patient’s mortality rate is approximately 20 percent. Within three years of amputation, 50% of survivors still require amputation of the contralateral lower limb. The 5-year survival rate for patients after amputation is very low, about 25%. Second, the diabetic foot examination history and clinical examination found the following risk factors should be given special attention, strengthen follow-up and targeted to take effective preventive and curative measures: 1, past history of foot ulcers; 2, symptoms of neurovascular pathology (numbness, sensation of touch or loss of pain in the foot) and/or ischemic vasculopathy (exercise induced pain in the gastrocnemius muscle or cold feet); 3, neurovascular pathology signs (hot feet, non-sweaty skin, muscle atrophy, eagle’s claw-like toes, thickened skin at pressure points, very good pulse, good blood filling) and/or signs of peripheral vasculopathy (cold feet, thin shiny skin, loss of pulse and atrophy of subcutaneous tissue); 4. other chronic complications of diabetes (severe renal failure or kidney transplantation, significant retinopathy); 5. neurological and/or vascular lesions that are not severe but with severe foot deformity; 6. other risk factors, such as decreased vision, orthopedic problems that affect foot function such as knee, hip or spine arthritis, poorly fitting footwear, etc.; 7. personal factors, such as poor socioeconomic conditions, old age or living alone, refusal of treatment and care, etc. The frequency of follow-up for diabetic foot should depend on the type and extent of the condition. For example, patients with plantar ulcers should be followed up more frequently, and can be reviewed once every 1 to 3 weeks; patients with foot sensory loss can be reviewed once every 3 months. Third, the prevention of diabetic foot prevention should be said to be a systematic project, covering many aspects of life and living, as summarized in the following eight sentences. 1, blood sugar control is the most important diabetic foot is mainly due to diabetes caused by peripheral vascular and neuropathy of the limb secondary to infection, and control of blood sugar is an effective means to slow down the occurrence of peripheral vascular and neuropathy. And high blood sugar is also prone to infection, so strict control of blood sugar is a very critical step. At the same time, blood pressure lowering and lipid regulating treatment should be actively carried out to control blood pressure and lipid to the ideal range, which is also very important for the prevention and treatment of diabetic foot. Therefore, diabetic patients are required to take active comprehensive treatment, rational use of drugs and strict blood glucose control. For patients with vascular lesions and neuropathy should take targeted treatment to prevent the further development of lesions. 2, prohibit smoking in mind Smoking can directly lead to occlusive vasculitis, smoking is also a diabetic vasculopathy promoting factors, can be said to be the accomplice of diabetic foot, therefore, diabetic patients should advocate smoking cessation, for has occurred vasculopathy, even foot lesions of diabetic patients must quit smoking. 3, foot examination is indispensable All patients, especially patients with vascular and neuropathic lesions should insist on daily foot examination. Before washing the feet in a bright place to check the foot, between the toes, the palm of the foot, if necessary, with the help of a mirror or by family members. Note whether there are blisters, abrasions, cracks, calluses and corns on the skin of the foot, and whether there is localized skin redness and swelling. Note whether the toenail is too long, too thick, color changes, whether there are ingrown nails or splitting, such as serious cases, please immediately seek medical advice. 4, foot washing method to appropriate foot washing application of warm water and mild soap, before washing the best available back of the hand or elbow to check the water temperature. General foot soaking time to 5-10 minutes is appropriate, do not use hot water to wash your feet. After washing the feet should be clean, soft, absorbent towel will gently dry feet do not rub, especially to keep the skin between the toes clean and dry. 5, shoes and socks must be comfortable shoes should be the right size, toe wide, breathable, comfortable to wear, not crowded feet. Socks should be absorbent, breathable, soft and warm. Pure wool or cotton products are better, and the socks should be loose so as not to affect blood circulation. Socks should be changed and washed daily to keep them clean. Before wearing shoes, you should check if there are foreign objects such as small grit or unevenness in the shoes. Wear new shoes for no more than half an hour on the first day to check that the foot has not been squeezed or rubbed. If the sole of the foot is deformed, special shoes should be ordered to prevent the foot from being abraded. Do not walk barefoot, or wear sandals or slippers barefoot to prevent foreign objects from damaging the skin of the foot. 6, toenail trimming to avoid injury after washing the feet, toenails are soft when the best toenail trimming, patients with poor eyesight or shaky hands, family members should help trim to use nail clippers. Toenail should be cut straight, do not cut diagonally to avoid injury to the nail groove. Generally cut to the same level as the tip of the toe, not too close to the skin. If you hurt your skin by cutting your toenails, you should go to the hospital immediately. Calluses on the feet, corns do not just trim, it is best to ask professionals to deal with. 7, winter warm feet is not desirable winter do not use hot water bags, electric blankets, fireplaces and physical therapy instruments to warm the feet to avoid burns. Adhere to the calf and foot exercise every day. 8, foot micro-injuries need to be careful Foot is often the cause of foot infection, and thus diabetic patients should be actively treated foot. For small wounds on the foot need to be handled carefully, should seek medical attention early. It is best to let professionals inspect the foot once a year to detect problems in a timely manner.