Paisey RB, et al. - Over 18 years, researchers assessed the impact of improvements in diabetic foot service on incidence of diabetic foot ulceration and how survival time from first ulcer development is impacted by the presence of neuropathy, peripheral vascular disease, age, and healing. A decrease in first presentations of diabetic foot ulceration was significantly noted after 18 years of integrated care for the diabetic foot, but it failed to reduce recurrent ulceration. The increasing prevalence of all ulcers continues, but, in the absence of peripheral vascular disease, survival in persons < 65 years is better than seen before. Ten-year survival was 85% for those with first ulcer aged < 65 years, 50% for those aged 65–74 years and 25% for those aged 75–81 years. Five-year survival was 35% in those with peripheral vascular disease.