Cary, N.C. — Diabetes patients not only have to keep track of their diet, their blood-sugar level and their weight, they also have to watch their feet closely.

Diabetes is the No. 1 cause of foot amputations, because the disease can reduce blood flow to the feet, making wounds slow to heal.

The loss of sensation in the foot is another common problem among diabetics, because they don't always know when their foot might be cut, bruised or blistered.

That's why a podiatrist can be a diabetic's best friend.

Larry Lee, 67, has been going to a podiatrist every three months as a way to help manage the diabetes he has had for 30 years.

"(Patients) are coming as a preventative measure, so that we can talk about their circulation," said Dr. Jeremy Thomas, a podiatrist in Cary. "We can talk about diabetic shoes, diabetic foot washes, diabetic creams."

A while back, Thomas prescribed special socks and custom-made shoes for Lee, tailored to his foot and with custom inserts.

"A lot of people will say it almost feels like they're walking on clouds or walking on marshmallows when they're walking around,” Thomas said.

They're for comfort and protection, as opposed to going barefoot or wearing flip-flops or sandals everywhere.

"The American Diabetes Association stresses all the time that a diabetic should never go without socks and shoes," Thomas said. "They always need to be in shoes."

A routine office visit includes a circulation check - looking for problems with sensation - and some patients, like Lee, let their toenails grow until they see their podiatrist.

"It's difficult for me to cut them at this stage of my life, so (the doctor) makes sure that they're cut and cleaned and gives me advice on how to take care of them," Lee said.

Thomas also recommends daily foot creams and lotions.

"It's a protective measure to help break down from dry skin that can form ulceration," he said.

It's the kind of care that gives Lee the same kind of comfort he gets from his shoes – knowing that diabetes doesn't have to take him off his feet.