This fifty-nine year old came to our attention in mid-June 2016 after moving to the area and after admission to an in-patient stay as a result of presenting at A&E with foot ulceration. There was a sixteen year history of Type 2 diabetes. Neuropathic ulceration on both feet had been present for about four months and had recently been exacerbated by increased walking and dancing while on holiday. In addition, and secondary to plantar ulceration, osteomyelitis had developed in the left great toe. This was confirmed by x-ray examination which also highlighted a pathological fracture in the proximal end of the shaft of the distal phalanx with subluxation at the interphalangeal joint.
Foot ulceration had been an issue in the past for the patient.
The patient appeared fully aware of the implications of active foot disease.