Why should people with diabetes check their feet regularly?

Diabetes can impair both blood flow and nerve sensitivity in the feet. Poor circulation means that tiny cuts, ulcerations, cracks in the skin, or other minor injuries can become infected, and because of poor nerve functioning, a person with diabetes may not notice.

Untreated infections can progress so quickly that the foot or lower leg may have to be amputated. There were nearly 82,000 such amputations among diabetics in 2002 alone, according to the National Diabetes Education Program, part of the National Institutes of Health.

More than 40,000 of these cases could be avoided if people with diabetes checked their feet daily, primary-care providers examined patients' feet at every visit, and people with poor circulation or poor nerve function saw a podiatrist regularly, said Dr. Martin Abrahamson , medical director of the Joslin Diabetes Center. "Care of the feet is a high priority for people with diabetes," he said. When a person gets a foot infection and can't feel it, "the next thing you know, it can get rip-roaring -- it can get exponentially much worse."

If you have diabetes, the podiatric group says, you should inspect your feet daily, wash and dry them (including between the toes), cut toenails straight across, keep feet warm and dry, use moisturizer to keep feet from cracking, and wear comfortable, well-fitting shoes. You should never go barefoot, cut or burn corns or calluses off yourself, or wear shoes that irritate the feet, such as flip-flops.

JUDY FOREMAN

E-mail health questions to Foreman@globe.com.