Clinical implications of diabetes on the foot.

OBJECTIVE: Athletic trainers must understand the clinical implications of diabetes on the athletic foot in order to promote proper foot care and footwear and to adapt protocols for treatment and exercise of the affected athlete. DATA SOURCES: The MEDLINE and CINAHL databases were searched for the years 1984 to 1996 with the terms "diabetes and foot," "neuropathy," and "Charcot joint." DATA SYNTHESIS: As more athletes with diabetes participate in sports, athletic trainers must develop the skills and knowledge necessary to manage this metabolic illness. Although the need to keep blood glucose levels carefully controlled is well known, the impact of diabetes on the foot is not as well recognized. Peripheral vascular disease, soft tissue neuropathy, and neuropathic arthropathy are the most common complications of diabetes affecting the foot. However, with proper management, these complications can be minimized, allowing diabetic athletes and nonathletes to lead more normal and functional lives. CONCLUSIONS/RECOMMENDATIONS: The athletic trainer can assist the diabetic athlete by promoting proper foot care and footwear and adapting protocols for treatment and exercise.