Foot ulcers and amputations are a major cause of morbidity and increased costs for people with diabetes. Studies have shown that identification of people at risk for ulcers and/or amputation is critical and that preventive therapy, particularly for those at risk, is often effective. Risk  for ulcer or amputation is increased in people who have had diabetes >=10 years, are male, have poor glucose control, or have cardiovascular, renal, or retinal complications. Amputation incidence is rising in many medical centers. Risk factors that can be identified on examination include peripheral neuropathy with decreased sensation, altered] foot biomechanics with neuropathy (callus or bony deformity), and decreased posterior tibial or pedal pulses.

Care guidelines, therefore, include an annual foot examination for all patients with diabetes and at every visit for those with peripheral neuropathy.

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