Hello.Welcome.Distinguish between ischaemia(absent DORSALIS PEDIS pulse) and peripheral neuropathy
.In practice many have both.In neuropathy sensations are decreased and ankle jerks absent.Ischemia
is confirmed by DOPPLER test.Any evidence of neuropathy or ischemia puts the patient at risk of foot ulcers
which are usually painless.Management irregular chiropody,relieve high pressure areas with therapeutic shoes and antibiotics for infection. Amputation
becomes necessary if gangrene takes place.So all diabetics must take special care of their feet.Good luck.