Figures released by the International Diabetes Federation suggest that worldwide in 2003 there were almost 200 million people with diabetes – a global prevalence of 5.1%. The report predicted that over the coming decade, the greatest increases in the numbers of people with the condition will occur in Africa and Asia, provoking hugely increased rates of death and disability. Diabetes foot complications constitute a major public health problem, particularly for people with diabetes in developing countries. In this article, Zulfiqarali Abbas and Stephan Morbach look at the factors that are specific to developing regions, which compound the damage caused by the diabetic foot.