There are 285 million people living with diabetes worldwide, the number of affected people is predicted to reach 438 million by 2030. Because of the rapid increase in diabetes prevalence, the number of diabetes complications is rising equally quickly. Amputation is one of the most feared of these complications. People with diabetes are at risk for nerve damage and problems with the supply of blood to their feet. Nerve damage results in a reduced ability to feel pain and, as a consequence, injuries often go unnoticed. Moreover, poor blood supply can slow down the process of wound healing. These factors can lead to ulceration. Infected foot ulcers can ultimately result in amputation. In this article, an international team of authors reports on an ambitious new initiative aimed at reducing the burden of diabetic foot problems in the Caribbean.