Enhanced population longevity, decrease in physical activity and the obesity pandemic have resulted in an increase in incidence of type 2 diabetes in all WHO health care areas. The prevalence of the condition has been further increased by an increase in life expectancy of those living with both type 1 and type 2 diabetes as a result of lifestyle and therapeutic interventions. Microvascular complications of type 1 and type 2 diabetes mellitus are related to duration of the condition and include neuropathy in 20% of cases in all cultures. Diabetic peripheral neuropathy in combination with propensity to distal peripheral vascular disease, poor healing, infection and foot deformities often result in foot ulceration and a uniquely high minor and major amputation risk. The risk for foot ulceration is modified by ethnicity (foot flexibility) and life style (footwear and culture of walking bare-foot). Once a deep diabetic foot ulcer has developed the epidermis, dermis, tendon insertions and bone architecture will never return to normal . The lack of resilience in the scar tissue formed and foot deformity after a deep ulcer will confer a high risk of re-ulceration-in fact previous foot ulceration is by far the highest risk factor for occurrence of a foot wound in persons living with diabetes.