Diabetes is now the biggest cause of amputation, stroke, blindness and end stage renal failure. It causes many deaths from cardiovascular disease. Foot ulcers and amputations reduce the quality of life, increase mortality and involve lengthy stay in hospital. Many people who have an ulcer eventually require surgery. The economic cost to the nation is spiralling out of control with estimates of 10% of the entire NHS budget spent on diabetes. This paper aims to explore the burden of diabetic complications and how policy, guidelines and audit highlight the discrepancies in the quality of diabetes care with particular reference to diabetes foot services. The findings suggest that the NICE guidelines for diabetes foot care are not being adhered to and that the variation in preventative amputations across England is unacceptable. Diabetes UK, the national charity for diabetes is leading a campaign to improve diabetic foot care in light of the available published health information.