Prevent diabetes problems
 

Keep your feet healthy 

Number 

5

in a 

Series 

of 7 

National Diabetes Information 

Clearinghouse 

Prevent diabetes problems: 

Keep your feet healthy 

Contents
 

How can diabetes affect my feet? ........................... 1
 

What common foot problems can lead to 

pain or infections?.................................................... 4 

How can diabetes change the shape of 

my feet?................................................................... 13
 

How can special shoes or shoe inserts 


help my feet? .......................................................... 15
 

How often should I have a foot exam?................. 15
 

How does smoking affect my feet?........................17 


How can I keep my feet healthy?.......................... 18
 

Pronunciation Guide.............................................. 25
 

For More Information ........................................... 26
 

More in the Series .................................................. 29
 

Acknowledgments .................................................. 30
 

 

How can diabetes affect my feet? 

Too much glucose,* also called sugar, in your blood 

from diabetes can cause nerve damage and poor 

blood flow, which can lead to serious foot problems. 

*See the Pronunciation Guide for tips on how to 

say the words in bold type. 

Nerve Damage 

Damaged nerves may stop sending signals, or they 

may send signals too slowly or at the wrong times. 

Nerve damage can cause you to lose feeling in your 

feet. You may not feel pain, heat, or cold in your 

legs and feet. You may not feel a pebble inside 

your sock that is causing a sore. You may not feel 

a blister caused by poorly fitting shoes. 

Sores on your feet can become infected. If your 

blood glucose is high, the extra glucose feeds the 

infection in those sores and the infection gets 

worse. Nerve damage can also cause pain and 

lead to foot deformities, or changes in the muscles, 

bones, and shape of your feet. 

1 
Poor Blood Flow 

Poor blood flow means not enough blood flows 

to your legs and feet through your blood vessels. 

Poor blood flow makes it hard for a sore or an 

infection to heal. This problem is called peripheral 

artery disease, also called PAD. 

Sometimes, a bad infection never heals. The 

infection might cause gangrene. If you have 

gangrene, the skin and tissue around the sore die. 

The area becomes black and smelly. 

Nerve 

Bone 

Blood 

vessel 

Too much glucose, also called 

sugar, in your blood from 

diabetes can cause nerve damage 

and poor blood flow, which can 

lead to serious foot problems. 

2 
Prompt attention to any sore or infection on your 

toe or foot can prevent gangrene. Your doctor may 

decide to cut away the infected tissue or give you 

antibiotics. Your doctor also may perform tests 

to see how well blood is reaching your legs and 

feet. Sometimes, your doctor may be able to clear 

blocked blood vessels to improve the blood flow. 

If these treatments don’t work, or if you have 

severe pain or infection, a doctor may have to 

perform an amputation—surgery to cut off a body 

part—of your toe, foot, or part of your leg. A 

surgeon performs this operation in a hospital. You 

will receive anesthesia and be asleep during the 

operation. 

3 
 

 

What common foot problems can lead 

to pain or infections? 

If you have diabetes, the common foot problems 

below can lead to pain or infections that make it hard 

to walk. If you have any of these problems, make 

sure you get prompt treatment from your doctor. 

Corn and callus 

Corns and calluses 

are thick layers 

of skin. 

Callus 

● 	 

Corn 

➔

➔

Corns and calluses are 

caused by too much rubbing 

or pressure on the same 

spot. They often form 

where the first and second 

toes overlap. 

● 	 You can gently rub a pumice 

stone on a corn or callus 

after you take a bath or 

shower to wear it down. A 

pumice stone is a type of 

rock used to smooth the skin. 

However, check with your 

doctor about the best way to 

care for a corn or callus. 

● 	 If an infection occurs in an 

area of a corn or callus, your 

doctor may need to remove 

the unhealthy tissue and 

give you antibiotics. 

4 
 

 

 

Blister 

Blisters are 

areas of skin 

that are raised 

and filled with 

fluid. 

➔

● 	 A blister can form if your 

shoe always rubs the same

spot on your foot.

● 	 Wearing shoes that do not 

fit or wearing shoes without

socks also can cause blisters. 

● To prevent a blister, use 

socks or a bandage over the 

spot being rubbed. Wear 

shoes that fit properly. 

● 	 Cover small blisters with a 

bandage, and cover large 

ones with a gauze pad held 

with adhesive or paper tape. 

You also can buy special 

blister bandages in different 

sizes at a drugstore. 

● 	 If your blister is infected, 

your doctor may need 

to drain the fluid from 

the blister and give you 

antibiotics. 

5 
 

 

 

 

Ingrown toenail 

Ingrown toenails 

happen when the 

edges of your 

toenails grow into 

your skin. 

6 

➔

● 	 Ingrown toenails can form if 

you wear shoes that are too 

tight or cut into the corners 

of your toenails when you 

trim them. 

● 	 To prevent ingrown toenails, 

wear shoes that fit properly. 

● 	 If your toenail edges are 

sharp, smooth them with 

a nail file or emery board 

instead of cutting them. 

● 	 If you go to a salon for a 

pedicure, make sure they do 

not cut into the corners of 

your toenails. Never treat 

ingrown toenails at home. 

Your doctor may remove 

part of your toenail to 

help it heal or keep it from 

growing back into your skin. 

If your toe is infected, you 

may need antibiotics. 
 

 

 

Bunion 

A bunion is a 

bump at the 

outside edge of 

your big toe. As 

the bump gets 

worse, it can be 

filled with extra 

bone and fluid. 

➔

● 	 Bunions form when your big 

toe slants toward your small 

toes. High heels, pointed 

shoes, or shoes that are too 

tight or narrow may cause 

bunions. Bunions often run 

in families. 

● 	 To prevent bunions, wear 

shoes that fit well. 

● 	 Your doctor may suggest 

using padded shoe inserts 

to prevent a bunion from 

getting worse and using 

medicine to reduce pain 

and swelling. You may need 

surgery to remove a bunion 

that causes frequent pain. 

7 
 

 

 

 

 

Plantar warts 

Plantar warts 

are small, fleshcolored growths 

on the bottoms 

of your feet. 

Sometimes you 

see tiny, black dots 

in the warts. 

8 

➔

● 	 Plantar warts are caused 

by a virus that enters your 

feet through small breaks in 

your skin. The warts can be 

painful and make it hard to 

walk. 

● 	 To prevent plantar warts 

from spreading, avoid 

contact with your warts 

and wash your hands after 

touching them. 

● 	 Keep your feet clean and 

dry. 

● 	 Don’t go barefoot in public 

areas. 

● 	 Your doctor may remove 

plantar warts with minor 

surgery, laser treatment, 

liquid nitrogen, or 

medicines. 
 

 

 

 

 

Hammertoe 

Hammertoes are 

toes that curl 

under your feet. 

●

●

●

●

●

●

➔

Hammertoes form when 

one or both joints of the 

small toes bend from 

weakness in your foot 

muscle. Diabetic nerve 

damage may cause the 

weakness. 

You may get sores on the 

bottoms of your feet and on 

the tops of your toes that 

can become infected. 

The shape of your feet may 

change. 

You can have problems 

walking and finding shoes 

that fit well. 

Avoid high heels or shoes 

with pointed toes. 

Your doctor may give you an 

orthotic, or insert, to place 

in your shoe. Medicines can 

reduce pain and swelling. If 

your hammertoe becomes 

rigid and painful, or if an 

open sore has formed, you 

may need surgery to correct 

your toe. 

9 
 

 

 

Dry and cracked 

skin 

Dry and cracked 

skin is rough, 

scaly, and flaking. 

Your skin may be 

gray if you have 

dark skin. Your 

skin may be red 

or itch. 

➔

● 	 Dry and cracked skin can 

be caused by high blood 

glucose, nerve damage, or 

poor blood flow. 

● 	 Cracks allow infection to 

start. 

● 	 Keep your feet moist with 

lotion or petroleum jelly. 

● 	 Do not soak your feet 

because your skin could 

become drier. 

● 	 If you cannot treat your 

dry and cracked skin at 

home, see your doctor. You 

may need a prescription 

ointment or cream. 

10 
 

 

 

 

Athlete’s foot 

Athlete’s foot is a 

fungus that causes 

itching, burning, 

redness, and 

cracking of your 

skin. The fungus 

grows on the soles 

of your feet and in 

between your toes. 

➔

● To prevent athlete’s foot, 

keep your feet as dry as you 

can. 

● Try not to wear the same 

shoes all the time. Try to 

wear socks that do not trap 

moisture, such as cotton or 

wool socks. 

● Wear waterproof shoes or 

flip-flops in public showers. 

● If you go to a salon for a 

pedicure, ensure the tools 

are sterilized or bring your 

own tools. 

● See your doctor to make 

sure you have athlete’s 

foot. You can buy sprays 

and creams to treat fungus 

at a drugstore; however, 

your doctor may prescribe a 

stronger oral medicine. 

11 
●

●

●

●

 

Fungal infection 

Fungal infection 

of the toenails 

makes them thick, 

hard to cut, and 

appear yellow, 

green, brown, or 

black. A nail may 

also fall off. 

➔

To prevent a fungal infection 

of the toenails, keep your 

feet as dry as you can. 

Try not to wear the same 

shoes all the time. Try to 

wear socks that do not trap 

moisture, such as cotton or 

wool socks. 

Wear waterproof shoes or 

flip-flops in public showers. 

If you go to a salon for a 

pedicure, ensure the tools 

are sterilized or bring your 

own tools. 

● See your doctor to make 

sure you have a fungal 

infection of the toenails. 

Your doctor may prescribe 

an oral medicine to treat 

them. Sometimes, a doctor 

may remove the nail 

surgically or chemically or 

perform laser treatment. A 

laser beam can go deep into 

the nail tissue and kill the 

fungus; however, doctors 

are still studying how well 

this treatment works. 

12 
Signs of infection on your feet include 

● pus 

● redness 

● increasing pain 

● warm skin 

Call or see your doctor right away if you have 

any of these signs. 

How can diabetes change the shape 

of my feet? 

Nerve damage from diabetes can lead to changes 

in the shape of your feet. The damaged nerves 

cannot send messages to your foot muscles about 

movement. Your foot muscles become weak and 

imbalanced. The bones of your feet and toes may 

shift. 

Nerve damage from diabetes also causes Charcot’s 

foot, a problem in which the joints and soft tissue 

in your foot are destroyed. 

In the early stages of Charcot’s foot, your joints 

are stiff and collect fluid. The problem can quickly 

worsen. Your bones can slip out of place, making 

your foot look deformed. 

13 
You might not sense pain, so you may keep walking 

on your foot, making the problem worse. Without 

knowing it, you could injure and damage the joints 

or break a bone in your foot. 

The symptoms of Charcot’s foot appear quickly 

and include 

● warm, red skin 

● swelling 

● pain 

Your doctor may first treat Charcot’s foot by 

placing your foot in a cast and asking you to walk 

only with crutches or use a wheelchair. You may 

need surgery to correct the placement of the bones. 

Charcot’s foot 

14 
How can special shoes or shoe inserts help 

my feet? 

Special shoes or shoe inserts can be made to 

fit softly around and protect sore feet or feet 

that have changed shape. Medicare Part B 

insurance and other health insurance programs 

may help pay for these shoes or inserts. Ask 

your doctor whether your special shoes or 

inserts are covered by your insurance. 

How often should I have a foot exam? 

See your doctor at least once a year for a foot 

exam, or more often if you have foot problems. 

During the exam, your doctor will 

● 	 look at your feet for signs of problems, especially 

if you have nerve damage 

● 	 test the sense of feeling in your feet 

● 	 test how well blood is flowing to your legs and 

feet 

15 
● 	 show you how to care for your feet 

● 	 decide if special shoes or shoe inserts would help 

your feet stay healthy 

● 	 trim your toenails if you cannot trim your own 

Help your doctor care for your feet during every 

checkup. Start every checkup by taking off your 

shoes and socks. Tell your doctor about any foot 

problems you are having. If needed, your doctor 

may send you to a foot doctor, called a podiatrist. 

Start every checkup by taking 

off your shoes and socks. 

16 
How does smoking affect my feet? 

Smoking can narrow and harden the blood vessels 


that nourish your nerves with oxygen and nutrients. 


Nerve damage and poor blood flow can cause 


serious foot problems. 


Smoking and diabetes are a dangerous mix. 


Smoking raises your risk for many diabetes 


problems. If you quit smoking, 


● you will lower your risk for heart attack, stroke, 

nerve disease, kidney disease, and amputation 

● your cholesterol and blood pressure levels might 

improve 

● your blood circulation will improve 

If you smoke, stop smoking. Ask for help so that 

you don’t have to do it alone. You can start by 

calling 1–800–QUITNOW or 1–800–784–8669. 

17 
How can I keep my feet healthy? 

You can keep your feet healthy by taking these 

steps: 

● 	 If you smoke, get help to quit. 

● 	 See your doctor at least once a year for a foot 

exam, or more often if you have foot problems. 

Have your doctor check the sense of feeling in 

your feet and how well blood is flowing to your 

feet. 

● 	 Keep your blood glucose numbers as close 

to your target as possible. Your doctor will 

work with you to set your target blood glucose 

numbers and teach you what to do if your 

numbers are too high or too low. 

● 	 Check your feet every day for 

cuts, sores, blisters, redness, 

calluses, infected toenails, 

or other problems. You may 

have serious foot problems, 

even though you feel no 

pain. Checking every day 

is even more important if 

you have nerve damage or 

poor blood flow. If you have 

trouble bending over to see 

your feet, use a mirror to help. 

Check your feet 

every day. 

18
 
You also can ask a family member or friend to 

help you. Call or see your doctor right away if 

you have any foot problems. 

● 	 Wash your feet every day in warm, not hot, 

water. Test the temperature with your elbow 

or with a thermometer—90 to 95 degrees is 

safe. Do not soak your feet because your skin 

could dry out. Dry your feet well. Be sure to 

dry between your toes. Use talcum powder or 

cornstarch to keep the skin between your toes 

dry. 

● 	 Keep your skin soft and smooth. Rub a thin 

layer of lotion, cream, or petroleum jelly on the 

tops and bottoms of your feet after you wash and 

dry them. Do not put any between your toes 

because you might get an infection. 

● 	 Smooth corns and calluses. 

Rub gently, only in one 

direction, to keep from 

tearing your skin. Do not 

cut corns and calluses. 

Don’t use razor blades, corn 

plasters, or liquid corn and 

callus removers—they can 

damage your skin. 

19 
20

● Trim your toenails each week or when needed. 

Have your doctor trim your toenails if

•	 you can’t see well

•	 you can’t reach your feet

•	 your toenails are thick or yellowed

•	 you have an ingrown toenail

If you can see and reach your toenails, trim them 

with clippers after you wash and dry your feet. 

Trim toenails straight across and smooth them 

with an emery board or a nail file. Do not cut 

into the corners of your toenail. 

Trim toenails straight across 

and smooth them with an emery 

board or a nail file.
● 	 Wear shoes and socks at all times to protect your 

feet. Do not walk barefoot—not even indoors— 

because it is easy to step on something and hurt 

your feet. Always wear socks, stockings, or 

nylons with your shoes to help prevent blisters 

and sores. Choose clean, lightly padded socks 

that fit well. Socks that have no seams are best. 

Do not wear socks or knee-high stockings that 

are too tight below your knee. Check the inside 

of your shoes before you put them on to be sure 

they don’t have any sharp edges or objects in 

them and the lining is smooth. 

Check the inside of your 

shoes before you put 

them on. 

21 
 

 

 

 

● Wear shoes that fit well. Shoes that fit well can 

help prevent serious foot problems. Shop for 

shoes at the end of the day because your feet are 

slightly bigger then—feet tend to swell during 

the day. When buying shoes, make sure they feel 

good from the start and have room for your toes. 

Don’t buy shoes with pointed toes or high heels. 

They put too much pressure on your toes. Avoid 

open-toed shoes or sandals. Athletic or walking 

shoes are good for daily wear. They support your 

feet and allow air to move around inside the shoe. 

Never wear vinyl or plastic shoes because they 

don’t stretch or allow air to move around inside 

the shoe. Break in shoes slowly. Wear them 1 to 

2 hours each day for the first few weeks. 

Inside view of a 

properly fitted shoe 

Inside view of a 

poorly fitted shoe 

22 
● 	 Protect your feet from heat and cold. Wear 

shoes on hot pavement or at the beach. Put 

sunscreen on the tops of your feet to prevent 

sunburn. Keep your feet away from radiators 

and open fires. Do not put hot water bottles or 

heating pads on your feet. Wear socks at night if 

your feet get cold. In winter, wear lined boots to 

keep your feet warm. Check your feet often in 

cold weather to prevent frostbite. 

Wear shoes on hot pavement or at the beach. 

23 
● 	 Keep the blood flowing to your feet. Put your 

feet up when you are sitting. Wiggle your toes 

for 5 minutes two or three times a day. Move 

your ankles up and down and in and out to 

improve blood flow in your feet and legs. Do not 

cross your legs for long periods of time. 

● 	 Choose physical activities that are easy on your 

feet. Walking briskly, dancing, swimming, and 

bicycling are good forms of physical activity that 

are easy on your feet. Avoid activities that are 

hard on your feet, such as running and jumping. 

Wear athletic shoes that fit well and provide 

good support. 

Walking briskly is good physical 

activity that is easy on your feet. 

24 
Pronunciation Guide 

amputation (AM-pyoo-TAY-shuhn)
 

Charcot’s (SHAHR-kohz)
 

cholesterol (koh-LESS-tur-ol)
 

circulation (SUR-kyoo-LAY-shuhn)
 

deformities (duh-FOR-mih-teez)
 

gangrene (GANG-green)
 

glucose (GLOO-kohss)
 

nitrogen (NY-troh-jen)
 

orthotic (or-THOT-ik)
 

peripheral artery disease (puh-RIF-ur-uhl) 


 (AR-tur-ee) (dih-ZEEZ) 

podiatrist (poh-DY-uh-trist) 

pumice (PUHM-iss) 

25 
For More Information 

To find diabetes educators (nurses, dietitians, 

pharmacists, and other health care providers), 

contact 

American Association of Diabetes Educators 

200 West Madison Street, Suite 800 


Chicago, IL 60606 


Phone: 1–800–338–3633 


Internet: www.diabeteseducator.org 


To find dietitians, contact 

Academy of Nutrition and Dietetics 

120 South Riverside Plaza, Suite 2000 


Chicago, IL 60606–6995 


Internet: www.eatright.org 


Click on “Find a Registered Dietitian.”
 

26
 
To learn more about foot problems from diabetes, 

contact 

National Institute of Arthritis and 

Musculoskeletal and Skin Diseases 

Information Clearinghouse 

National Institutes of Health 

1 AMS Circle 

Bethesda, MD 20892–3675 

Phone: 1–877–22–NIAMS (1–877–226–4267) 

or 301–495–4484 

TTY: 301–565–2966 

Fax: 301–718–6366 

Email: NIAMSinfo@mail.nih.gov 

Internet: www.niams.nih.gov 

To get more information about taking care of 

diabetes, contact 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

27 
 

National Diabetes Education Program 

1 Diabetes Way 

Bethesda, MD 20814–9692 

Phone: 1–888–693–NDEP (1–888–693–6337) 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndep@mail.nih.gov 

Internet: 	www.ndep.nih.gov 

www.yourdiabetesinfo.org 

American Diabetes Association 

1701 North Beauregard Street 

Alexandria, VA 22311 

Phone: 1–800–DIABETES (1–800–342–2383) 

Email: askADA@diabetes.org 

Internet: www.diabetes.org 

JDRF 

26 Broadway, 14th Floor 

New York, NY 10004 

Phone: 1–800–533–CURE (1–800–533–2873) 

Fax: 212–785–9595 

Email: info@jdrf.org 

Internet: www.jdrf.org 

28 
More in the Series 

The Prevent Diabetes Problems Series includes 

seven booklets that can help you learn more about 

how to prevent diabetes problems: 

● Prevent diabetes problems: Keep your diabetes 

under control 

● Prevent diabetes problems: Keep your eyes healthy 

● Prevent diabetes problems: Keep your feet healthy 

● Prevent diabetes problems: Keep your heart and 

blood vessels healthy 

● Prevent diabetes problems: Keep your kidneys 

healthy 

● Prevent diabetes problems: Keep your mouth 

healthy 

● Prevent diabetes problems: Keep your nervous 

system healthy 

29 
For free single copies of these booklets, write, call, 

fax, or email the 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

These booklets are also available at 

www.diabetes.niddk.nih.gov. 

Acknowledgments 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists 

and outside experts. The National Diabetes 

Information Clearinghouse (NDIC) thanks David 

G. Armstrong, D.P.M., M.D., Ph.D., professor 

of surgery and director, Southern Arizona 

Limb Salvage Alliance (SALSA), University of 

Arizona, for reviewing the updated version of this 

publication. 

30
 
31

The NDIC also thanks the following people who 

helped review or field-test the original version of 

this publication:

For the American Association

of Diabetes Educators

Lynn Grieger, R.D., C.D.E.

Arlington, VT

Celia Levesque, R.N., C.D.E.

Montgomery, AL

Teresa McMahon,

Pharm.D., C.D.E.

Seattle, WA

Barbara Schreiner, R.N.,

M.N., C.D.E.

Galveston, TX

For the American Diabetes 

Association

Phyllis Barrier, M.S., R.D., 

C.D.E.

Alexandria, VA

Linda Haas, Ph.C., R.N.,

C.D.E.

Seattle, WA

Kathleen Mahoney, M.S.N.,

R.N., C.D.E.

Drexel Hill, PA

Randi Kington, M.S., R.N., 

C.S., C.D.E.

Hartford, CT

For the Centers for Medicare

& Medicaid Services

Baltimore, MD

Jan Drass, R.N., C.D.E.

For the Diabetes Research

 Centers

Albert Einstein School

of Medicine

Norwalk Hospital

Norwalk, CT

Jill Ely, R.N., C.D.E.

Sam Engel, M.D.

Pam Howard, A.P.R.N.,

C.D.E.

Indiana University School

 of Medicine

Indianapolis, IN

Madelyn Wheeler, M.S.,

R.D., F.A.D.A., C.D.E.

VA/JDF Diabetes Research 

Center

Vanderbilt School of

Medicine

Nashville, TN

Ok Chon Allison, M.S.N.,

R.N.C.S., A.N.P., C.D.E.

Barbara Backer, B.S.

James W. Pichert, Ph.D.

Alvin Powers, M.D.

Melissa E. Schweikhart

Michael B. Smith

Kathleen Wolffe, R.N.

For the Grady Health

System Diabetes Clinic

Atlanta, GA

Ernestine Baker, R.N.,

F.N.P., C.D.E.

Kris Ernst, R.N., C.D.E.

Margaret Fowke, R.D., L.D.

Kay Mann, R.N., C.D.E.

For the Indian Health

Service

Albuquerque, NM

Ruth Bear, R.D., C.D.E.

Dorinda Bradley, R.N.,

C.D.E.

Terry Fisher, R.N.

Lorraine Valdez, R.N.,

C.D.E.

Red Lake, MN

Charmaine Branchaud,

B.S.N., R.N., C.D.E.

For the Medlantic Research 

Center

Washington, D.C.

Resa Levetan, M.D.

For the Texas Diabetes

Council

Texas Department of

Health

Austin, TX

Luby Garza-Abijaoude,

M.S., R.D., L.D.
 

National Diabetes Education Program 

1 Diabetes Way 

Bethesda, MD 20814–9692 

Phone: 1–888–693–NDEP (1–888–693–6337) 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndep@mail.nih.gov 

Internet: www.ndep.nih.gov 

www.yourdiabetesinfo.org 

The National Diabetes Education Program is a 

federally funded program sponsored by the U.S. 

Department of Health and Human Services’ 

National Institutes of Health and the Centers for 

Disease Control and Prevention and includes over 

200 partners at the federal, state, and local levels, 

working together to reduce the morbidity and 

mortality associated with diabetes. 

32
 
 

National Diabetes Information 

Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

The National Diabetes Information Clearinghouse (NDIC) is 

a service of the National Institute of Diabetes and Digestive 

and Kidney Diseases (NIDDK). The NIDDK is part of the 

National Institutes of Health of the U.S. Department of Health 

and Human Services. Established in 1978, the Clearinghouse 

provides information about diabetes to people with diabetes and 

to their families, health care professionals, and the public. The 

NDIC answers inquiries, develops and distributes publications, 

and works closely with professional and patient organizations 

and Government agencies to coordinate resources about 

diabetes. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and 

distribute as many copies as desired. 

This publication is available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications 

and, when taken as prescribed, the conditions they treat. When 

prepared, this publication included the most current information 

available. For updates or for questions about any medications, 

contact the U.S. Food and Drug Administration toll-free at 

1–888–INFO–FDA (1–800–463–6332) or visit www.fda.gov. 

Consult your health care provider for more information. 
NIH Publication No. 14–4282 

February 2014

The NIDDK prints on recycled paper with bio-based ink.