Two per cent of the world's population have diabetes and of these, ten per cent will have a foot ulcer at any one time. Foot ulcers in diabetics are difficult to treat and very slow to heal. They result in more amputations than any other pathology. Severe ulcers are very debilitating, often require hospitalisation (half of all diabetic patients in hospital have foot ulcers) and can even result in death through complications such as gangrene and septicaemia. Foot problems in diabetic patients are very difficult to treat. Therefore visual recognition of presenting clinical signs is a vital component of early diagnosis and start of treatment. Treatment in this field is developing with the launch of 'synthetic' skin grafts such as Apligraf (Novartis). In the UK, the Department of Health published guidelines for the National Service Framework for Diabetes in December 2001. Alethea Foster was involved in the development of these guidelines. They are to be implemented in all...

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