Prevention is always important with diabetic conditions, and it is especially crucial with foot ulcers and pressure ulcers. Foot ulcers and foot and leg amputations could be reduced by up to 85 percent through foot care, skin care and other preventive measures, according to the U.S. Centers for Disease Control and Prevention (CDC). Steps to prevent ulcers and further complications include:

• Daily foot inspections. People with diabetes should check their feet daily, including between the toes, for cuts, blisters, sores, heel cracks and other problems. A long-handled mirror or a mirror on the floor can help. Patients should immediately notify their physician if a problem is present. Researchers have found that checking the soles with a handheld infrared thermometer can reveal a risk of foot ulcers if the reading is several degrees Fahrenheit above normal.
  
  
• Daily foot hygiene. The feet should be gently but thoroughly washed and patted dry. A physician can recommend whether to use balms, lotions or powders to protect the skin. Generally creams and oils should not be used between the toes because the moisture can result in infection and skin breakdown.
  
  
• Proper toenail care. Nails should be trimmed along the contour of the toe and any sharp edges filed, according to the American Medical Association. People with diabetes who have peripheral neuropathy, impaired eyesight or other conditions that complicate foot care are advised to see a specialist, such as a podiatrist, for their foot care.
  
  
• Proper footwear. Some researchers have found that special double-layer socks may reduce the risk of foot ulcers. Studies differ on whether special diabetic shoes are more effective than standard shoes. Correct fit of special or regular shoes appears to be the most important factor. Buying shoes late in the day can ensure a better fit because the feet tend to be less swollen in the morning. Having at least two pairs of shoes and alternating them every other day reduces the risk of pressure in the same location on the foot. It is important to avoid walking barefoot and using shoes without socks.
  
  
• Comprehensive foot exams by a physician. Patients at high risk, including those with diabetes, are advised to have a complete foot examination at least once a year to identify conditions that may lead to ulcer development. These risk factors include peripheral neuropathy, peripheral arterial disease, foot deformity and a history of ulcer or foot or leg amputation.

Early detection and management of people with high-risk foot conditions. According to the National Institutes of Health (NIH), studies have shown that patient education reduces foot ulcers and amputations.

The following measures can help prevent pressure ulcers as well as foot ulcers:

• Control of glucose (blood sugar). Hyperglycemia damages the nerves and impairs the immune system’s ability to fight infection. Close control of glucose results in better skin condition and a reduced risk of medical complications.

• Prevention or cessation of smoking. Smoking increases the risk of ulcers and slows healing because it impedes circulation.
  
  
• Control of hyperlipemia. High levels of cholesterol and other fats in the blood increase the risk of atherosclerosis, the hardening of the arteries that is a risk factor for ulcers.
  
  
• Interventions to improve facilities’ care. These steps include careful examination of patients and monitoring of the skin’s condition.

Prevention of pressure ulcer also includes:

• Keeping the skin clean and dry
  
  
• Teaching the patient how to shift weight in a wheelchair or bed
  
  
• Repositioning frequently, generally every two hours, by lifting rather than sliding the patient
  
  
• Use of special mattresses or wheelchair cushions
  
  
• Protection of prominent bony areas with padding