1. what can be done first is finding the cause of the disease so that necessary medical care with evaluation and management can be done. 2. patient has to be screened for: diabetes, high lipid profile,high blood pressure, sedentary life style, obesity, chronic smoking. 3. complete cessation of smoking and tobacco consumption, strict control of diabetes, reduction of weight, control of hypertension by salt restriction, treatment of hyperlipidemia by dietary modifications. 4. walk slowly at slower pace to avoid claudications. 5. raise the heel of shoes by 1/2 6. take maximum care to avoid injury to foot,as it may precipitate gangrene 7. controlled exercise programmes for 6 months by walking near to maximum pain tolerance (on a treadmill) significantly improve the painfree maximum walking distances.