In general we can confirm that the best defence against a disease is knowledge of its causes; once these causes have been identified it is possible to select the most appropriate treatments and prevent it.
In the presence of sensory neuropathy measures must be taken to inspect the foot frequently: evaluating the appropriateness of shoes, testing the temperature of the water in the foot bath with the elbow, not walking in sand with bare feet.
The following table shows the fundamental rules for prevention.

Table 4 - Basic rules for preventing wounds of the foot.

The presence of plantar excess pressure requires the use of arch supports which allow rebalancing of pressure peaks and shoes designed to hold both the foot and arch support together and to protect it from friction and pressure.
These shoes must be modelled on the patient’s foot or heat formed (Figure 62); in order to be able to accommodate any deformities which, in a normal shoe, might result in the formation of ulcers ( Figure 63).
All this, from diagnosis to the instruction to prescribe the appropriate orthesis (shoe plus arch support) must be carried out in the diabetology outpatients’ department.
All this must be carried out for all diabetic subjects, with a frequency suited to the stage of the disease.
The filmed sequence ( "Screening" ) shows a check-up to evaluate the risk of ulceration in a diabetic patient who has never had an ulcer of the foot.
The rest of the discussion concerns secondary prevention, namely prevention of subsequent ulceration in a subject who has already had an ulcer.
In this case it has been proven that that shoes with a rigid sole (boat-shaped) are required, with made-to-measure arch supports (Figure 64).
If the ulcer has led to a minor amputation, it is often necessary to have made-to-measure shoes ( Figure 65).
These patients also require frequent out-patient check-ups, at least every two months, in an out-patient clinic for the diabetic foot.