Every 30 seconds, a lower limb is amputated as a result of diabetes; of all the amputations in the world, about 70% are suffered by people with diabetes – foot ulceration being a key factor in developing regions. Yet these amputations can be prevented. As well as medical factors, numerous social and socio-environmental issues affect the development of diabetic foot problems. This report focuses on Africa-specific factors. Although in Africa neuropathy is a major contributing factor, it is not the only one: even a simple injury that becomes infected can be a precursor to amputation. The authors reflect on some of the factors affecting diabetes care in Senegal, and make some suggestions for improvements in the prevention and management of the diabetic foot.