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        On a rough estimate, nearly 20 per cent of all admissions to hospital are due to foot problems suffered by diabetics and nearly 5 to 10 per cent of them may need foot/leg amputation. Moreover. of all the non-traumatic amputations, approximately 50 per cent are related to diabetes.

        The economic and psychological stress for the family and the patient are enormous. This stresses the need for preventive foot care among diabetics, according to Dr S M Sujatha, MD (General Medicine), consultant, Sri Chakra Hospital, Nanganallur, near Chennai.

        Foot ailments show up in about half of the people who had diabetes for 20 years or more. The worse then proceeds like this: When persons with diabetes loses sensation in their legs and feet, they fail to notice damage to the skin and tissues. Such seemingly minor injuries such as cuts, bruises, blisters, corns, calluses, ingrown toe nails, would develop into areas of infected tissue known as neuropathic ulcers, Sujatha said.

        The care to be taken are: wash your feet daily with mild soap and dry them thoroughly, especially between the toes; inspect feet daily by using mirror; press gently and feel for tenderness or hot spots - this may indicate injury; if the skin on your feet is dry, apply a lanolin- base cream. If your feet perspires a lot, use talcum powder; use cotton socks without elastic; smooth out wrinkles in socks; wear good fitting broad size soft shoes (stitched not nailed); choose new shoes carefully (comfort is more important than style) and break them in slowly; canvas shoes/sandals with Velcro and Mc insole should be used; avoid foot injuries by wearing shoes or slippers around the house; trim toe nails to the contour of your toe. If you cannot see them well or reach them easily, have some one to do this for you; smoothen calluses with pumice stone.

        As far as foot wear, Hawaii slippers/strap slipper should not be used.

        Sandals are recommended. Shoes must be roomy, use of insoles in early foot lesions, use custom- made shoes for advanced diabetic lesions.

        For complete precautionary steps, keep your body weight under control; increased physical activity, meticulous attention to achievement of normal blood sugar, control of BP and lipid control.

        Lifestyle issues should be principles of healthy diet with low fat; no simple sugar; high fibre; small frequent meals; no fasting, no feasting; no fried, fast foods.

        Exercise regularly: Duration 30 to 60 minutes. Frequency: Minimum 5 days a week. Avoid complications: Warm up and cool down. Carefully select the type of exercise and its intensity

        Compliance: Make exercise enjoyable at convenient location.

        Managing stress in your life:

        Identify clear times for exercise and relaxation. Yoga, deep breathing techniques and meditation definitely help you to relax.

        Each and every person must educate oneself regarding diabetic complications and the self- care programmes on the home front that might not only help himself but can also save a life.