Diabetes-related foot disease remains one of the most severe, costly and life-altering complications of diabetes worldwide. It encompasses a spectrum of interrelated conditions, including peripheral neuropathy, peripheral arterial disease, ulceration, infection and Charcot neuro-osteoarthropathy, that together drive high rates of hospitalisation, disability and premature mortality. Despite advances in clinical knowledge and the availability of evidence-based guidelines, diabetes-related foot disease continues to account for the majority of non-traumatic lower limb amputations globally.
The global burden of diabetes is rising rapidly and unevenly. Current projections indicate a 45% increase in the number of adults living with diabetes worldwide between 2024 and 2050, with the largest relative increases expected in Africa (142%), the Middle East and North Africa (92%), Southeast Asia (73%) and South and Central America (45%). These trends are closely mirrored by rising rates of foot complications, particularly in low- and middle-income countries, where access to screening, specialist care and coordinated treatment remains limited (International Diabetes Federation, 2025).
Even in high-income countries, where multidisciplinary foot services and advanced diagnostics are available, health systems face growing challenges. Rising obesity and earlier onset of diabetes increase risk, while inconsistent access to structured patient education and healthcare professional training limits awareness of the relationship between glycaemic control, neuropathy, vascular disease and limb health. Across settings, the problem is not a lack of evidence, but a failure to implement that evidence consistently and at scale.
In October 2025, a multidisciplinary group of international experts convened in person and online in Kuala Lumpur, Malaysia, to address this persistent implementation gap. The meeting brought together clinicians, researchers and health system leaders from diverse regions to focus on practical, context-sensitive strategies for the prevention and management of diabetes-related foot disease across low-, middle- and high-income settings.
The aim of this document is not to restate existing guidelines, but to support their translation into routine practice. By consolidating expert consensus into practical frameworks, decision tools and implementation strategies, it seeks to help clinicians, health systems and policymakers reduce avoidable foot complications and preventable amputations.
Prof. Dr. Harikrishna KR Nair (Chair)
Prof. Dr. Zulfiqarali G Abbas (Co-Chair)
Download the PDF below to access the full consensus document
