High-risk factors of diabetic foot disease – lower limb ischemia The risk of diabetic foot disease is that when ulcers or infections occur, wounds are difficult to heal in a short period of time and necrosis is very likely to occur if they are not treated in a timely manner. Early and active treatment of high-risk factors that exist in the diabetic foot, such as foot ischemia, deformity, and calluses, can reduce the likelihood of ulcers. When you have the following conditions, you should promptly go to the hospital for examination: 1.Coldness of both feet and lower limbs, even in summer, such as covering with towel quilts, more obvious in winter. 2. Intermittent claudication, i.e. pain in the calf belly (i.e. gastrocnemius pain) after walking, especially walking a long distance (more than two stops), which is relieved after rest. 3.Pain even without walking (i.e. resting pain), aggravated by raising the lower limb and relieved by lowering the lower limb. 4.Foot ulcers appear on the edge of the foot, including the toe or heel, and are associated with trauma or wearing unsuitable shoes. 5.Gently move with the back of the hand from the shin to the dorsum of the foot up to the toes and always in contact with your own skin. Asymmetric changes in skin temperature on both sides may suggest unilateral ischemia on the cool side or infection on the hot side. 6. Use the tips of the index, middle, and ring fingers to touch the dorsalis pedis artery (next to the long extensor bunion tendon, which is next to the tendon that arches when the thumb is cocked) and the posterior tibial artery (just below the back of the inner ankle). When the pulsations of both the dorsalis pedis and posterior tibial arteries are weak or absent, there is a high probability of lower extremity ischemia. In the hospital, the following tests can quickly detect the presence of ischemia in the lower extremities: 1. Doppler ultrasound measurement of the ankle-brachial index (ABI < 0.9) can clarify the presence of ischemia. 2, Magnetic resonance angiography (MRA) of both lower extremities can further obvious the site and degree of stenosis, so that treatment options can be selected.