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There is a need to raise awareness of foot complications and to decrease amputations in people with diabetes. The cost of care for these patients is high once they develop foot complications. With the correct management up to 80% of amputations are preventable, and decision makers are acknowledging that they can play an important role in the prevention and treatment of foot complications and thereby reduce the amputation rate. Commissioning high quality footcare and auditing standards of foot management pathways will be beneficial, as will prompt patient referral to a multidisciplinary footcare team. Signposting of these services to patients and carers may be the most important factor in preventing a minor foot problem escalating to an amputation.

The foot attack: Where are the defence mechanisms?