People who have diabetes need to pay special attention to the feet. Diabetic patients face high risk of foot infections that are harder to heal and can become dangerous.

Individuals with diabetes account for more than 60 percent of nontraumatic foot or leg amputations, according to the U.S. Centers for Disease Control and Prevention (CDC). Most of these amputations stem from minor wounds and could have been prevented.

Diabetic foot care focuses on routine tending to the feet and prompt treatment of minor but potentially catastrophic injuries. Common problems that may lead to infection but that foot care can prevent include:

• Athlete’s foot. A contagious, itchy fungal infection that causes cracks in the skin. People with diabetes are prone to fungal infections, including nail fungus, ringworm, thrush and yeast infections. Athlete’s foot can spread to the toenails and make them thick and difficult to trim. It is treated with antifungal medication and may be prevented by wearing shower shoes in locker rooms and common bathing areas. Nail fungus  can also be treated with antifungals and prevented with good foot care.
  
  
• Blister. Fluid-filled lesion caused by repeated abrasion, such as a sandal strap rubbing against the ankle.
  
  
• Bunion. Painful swelling of the bursa (a sac containing friction-reducing fluid) at the big toe’s first joint, with the toe turning in toward the other toes.
  
  
• Calluses and corns. Thickening of the skin due to friction or pressure, such as from improperly fitting shoes. To prevent damage to the skin, diabetic patients are advised to avoid harsh over-the-counter remedies.
  
  
• Cracked skin. Minor lesions caused by dry skin, especially in the heels. Even the smallest openings allow infection to enter. Use of lotions or petroleum jelly can help prevent cracking.
  
  
• Hammertoes. Painful, claw-like curling of the toes caused by a weakened foot muscle that shortens the tendons. Sores can develop on the tops of the toes and bottom of the feet. Hammertoes can change the foot’s shape and make it hard to walk and to find shoes that fit. Causes include heredity and wearing shoes that are pointy or too short. Hammertoes can be treated with surgery, under local anesthesia, that lengthens the Achilles’ tendon.
  
  
• Ingrown toenails. An edge of the nail growing into the skin. Tight shoes and improperly cut nails can cause ingrown toenails.
  
  
• Plantar warts. Noncancerous growths on the bottom of the foot, caused by a common virus. Plantar warts can go away on their own, but a physician might recommend surgical removal if they are painful, spread or cause other problems. To allow healing, people should not walk on plantar ulcers. Patients with diabetes should avoid harsh over-the-counter remedies. Prevention includes wearing shower shoes in locker rooms and common bathing areas.
  
  
• Ulcer. Open wound caused by any of the above factors as well as other sources of trauma. Treatment includes antibiotics and wound care. If not tended to early, ulcer can destroy tissues, leading to gangrene and the risk of foot or leg amputation.
  

  

Diabetic patients with one or more of the following risk factors have an increased risk of developing severe foot problems:

• Severe foot deformity, such as Charcot foot
• No pulse in the foot
• Previous foot ulcer
• Previous amputation