How common are diabetes-related amputations in Singapore?

Around four lower-limb amputations are performed each day, and in 2021 close to 9 in 10 lower-limb amputees had diabetes. Singapore’s rate has been well above the OECD average.

Are diabetes-related amputations preventable?

Largely. SGH cites that roughly 85% of lower-limb amputations can be avoided with regular foot screening and good daily foot care.

How often should I get my feet screened?

At least once a year for everyone with diabetes, and more often — every 6 months or every 3 months — if you are moderate or high risk, as assessed by your care team.

Why shouldn’t I moisturise between my toes?

The skin there stays damp, and trapped moisture softens the skin and encourages fungal and bacterial infection — a common trigger for ulcers.

When should I get urgent help for my foot?

Immediately if you see a new ulcer or wound, spreading redness, swelling or warmth, pus, black tissue, a foul smell, or a sudden hot swollen foot — these can signal serious infection and risk of amputation.

Diabetic Foot Problems & Ulcers: Care & Prevention (Singapore)

Written & reviewed by the BestDoctors.sg editorial team · Last updated 1 Sep 2026 · General information, not medical advice

Quick answer. Diabetes threatens the feet through a dangerous combination: nerve damage dulls sensation so injuries go unnoticed, poor circulation slows healing, and high glucose raises infection risk – so a small cut or blister can progress to a foot ulcer and, in the worst case, amputation. Singapore has one of the higher diabetes-related amputation burdens among developed countries – around four lower-limb amputations a day, and in 2021 close to 9 in 10 people who had a lower-limb amputation had diabetes. The reassuring message is that most amputations are preventable: SGH cites that about a proportion can be avoided with regular screening and good foot care. See a doctor urgently for any new ulcer, spreading redness, swelling, pus or black tissue.

Managing diabetes, or worried about your blood-sugar control?

Message our care team on WhatsApp. Tell us what’s going on and we’ll help you find the right endocrinologist — free, with no obligation.

Chat with our care team on WhatsApp

Not sure who to see? Find the right specialist →

In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

Foot care is one of the highest-value things a person with diabetes can do, because the difference between a minor problem and a lost limb often comes down to noticing and treating a small injury early.

Red flags – act the same day. See a doctor, podiatrist or foot-care team urgently if you notice any new foot ulcer or wound, spreading redness, swelling or warmth, discharge or a bad smell, a black area of skin, or a fever with a foot wound. These can be signs of an infection that spreads fast in diabetes. Go to A&E for signs of serious infection or sepsis – feeling very unwell, confusion, or a fever with a fast heartbeat. Do not wait, even if the wound does not hurt.

What diabetic foot ulcers are

A diabetic foot ulcer is an open sore or wound, usually on the foot, that develops in people with diabetes. It commonly forms on the sole, the ball of the foot, the heel or over a bony prominence, and it may look like a crater in the skin, sometimes surrounded by hard skin or callus. Ulcers are considered a serious complication because they can be slow to heal and can become infected; if they are not managed well, the infection can reach deeper tissue and bone, and in the worst cases lead to amputation.

The most important message, however, is a hopeful one: diabetic foot ulcers are largely preventable, and when they are caught early they are very treatable. This is a major issue in Singapore’s large diabetes population, which is exactly why daily attention to the feet and regular professional screening matter so much. Most people who look after their feet, control their glucose and act quickly on any change will never progress to a serious wound.

Why diabetes causes them

Ulcers arise from a combination of problems that diabetes can cause over time. First is nerve damage, or diabetic neuropathy, which reduces sensation in the feet. When the protective feeling of pain is dulled, a cut, blister, burn or pressure point goes unnoticed, so the injury is not rested or treated and simply gets worse. Second is reduced blood flow from peripheral arterial disease, which starves the tissues of the oxygen and nutrients needed to repair skin, so wounds heal slowly or not at all. Third is a higher risk of infection, because high glucose weakens the body’s immune defences and bacteria take hold more easily.

Together these three factors let a small, everyday injury become an ulcer. Nerve damage can also change the shape of the foot and the way weight is distributed, creating new pressure points and calluses that break down into wounds. It is this quiet, painless chain of events – injury, pressure, poor healing, infection – that makes foot care so central to living well with diabetes.

Symptoms and warning signs

Because sensation is often reduced, the usual warning – pain – may be absent, so it is important to look as well as feel. Signs to watch for include:

A wound, sore, blister or crack in the skin that is not healing.
Redness, swelling or warmth in part of the foot.
Discharge, pus or a bad smell from a wound, or drainage that stains socks or shoes.
Hard skin, calluses, corns or a black area of skin.
Skin changes, or a foot that gradually changes shape.
Sometimes no pain at all, even with a significant wound, because of numbness.

Any of these deserves prompt attention. A painless wound is not a reassuring wound – in diabetes it can be the opposite, because the lack of pain is a sign that the protective nerve signals have been lost.

Who is at higher risk

Everyone with diabetes should care for their feet, but some people carry a higher risk and need closer monitoring. Risk is greater with:

Long-standing diabetes, or diabetes that has been poorly controlled.
Established nerve damage (neuropathy) or reduced sensation.
Poor circulation or peripheral arterial disease.
A previous foot ulcer or amputation.
Foot deformities that create pressure points.
Smoking, which further narrows blood vessels.
Kidney disease.

Knowing you are higher-risk is useful rather than alarming: it simply means more frequent professional screening, extra care with footwear, and a lower threshold for seeking help early.

How they are assessed and treated

Diabetic foot ulcers are best managed by a foot-care or wound team – which may include a GP, a podiatrist, a diabetic foot or wound-care clinic, and, where blood flow is a concern, a vascular surgeon. Assessment looks at the wound itself, tests sensation and circulation, checks for infection, and considers whether deeper tissue or bone is involved.

Treatment usually combines several strands. The wound is cleaned and dressed, and dead or unhealthy tissue is removed so healthy tissue can heal. Crucially, pressure is taken off the ulcer – this is called offloading, and may involve special footwear, padding or a cast so the wound is not repeatedly reinjured by walking. Infection is treated with antibiotics where needed. If circulation is poor, the team may work to improve blood flow, sometimes with a vascular procedure. Throughout, controlling blood sugar, blood pressure and cholesterol supports healing, and in some cases surgery is required. Deep or infected ulcers, or any wound with black tissue, need urgent specialist care – these are not wounds to manage at home.

Preventing diabetic foot ulcers

Prevention is the practical heart of foot care, and most of it can be done at home. Small, consistent habits prevent the large majority of serious problems.

Check both feet every day, including the soles and between the toes; use a mirror or ask a family member to help if you cannot see them easily.
Keep feet clean and dry with good hygiene, and moisturise dry skin – but not between the toes, where trapped moisture softens skin and invites infection.
Wear well-fitting, covered shoes and clean socks, check inside shoes before putting them on, and never walk barefoot, even indoors.
Care for nails and calluses carefully; cut nails straight across, and if your sensation is reduced, have nails, corns and calluses treated professionally by a podiatrist rather than cutting or using corn removers yourself.
Do not use hot water bottles, heat pads or very hot water on numb feet, and test bath water with an elbow – numbness makes burns easy to miss.
Manage the underlying condition: keep blood sugar, blood pressure and cholesterol on track, eat well, stay active and stop smoking.
Attend regular professional foot screening, which checks sensation, circulation and skin, so higher-risk feet are picked up early.

These steps sit alongside broader diabetes care; you can read more about lowering diabetes risk in our guide to preventing type 2 diabetes, and about specialists in our directory of endocrinologists in Singapore. National resources such as Diabetes Singapore and HealthHub also offer practical foot-care guidance.

When to seek urgent help

See a doctor, podiatrist or foot-care team the same day for any new ulcer or wound, spreading redness, swelling or warmth, discharge, pus or a bad smell, a black area of skin, or a fever with a foot wound. A foot that suddenly becomes hot, swollen and red, or a new change in foot pain or numbness, also needs prompt assessment. Go to A&E if you feel very unwell, become confused, or have a fever with a fast heartbeat – these can be signs of a serious, spreading infection. Do not wait, even if the wound does not hurt: in diabetes, early treatment is what saves limbs.

Related conditions & guides

Sources

Ministry of Health (MOH), Singapore — diabetes-related lower-limb amputation figures (2021: close to 9 in 10 amputees had diabetes; rate above the OECD average); War on Diabetes.
Singapore General Hospital (SGH) — managing the diabetic foot in primary care (~a proportion of amputations avoidable; risk-based screening; daily foot-care advice); SGH Podiatry — diabetes foot care.
NHS / American Diabetes Association — diabetic foot: ulcers, daily foot care, and urgent warning signs.

General information only. This guide is general information about a medical condition and is not a diagnosis or personalised medical advice. Symptoms overlap between conditions, so see a doctor — a GP or an endocrinologist — for assessment, testing and treatment. In a medical emergency, call 995.

Diabetic Foot Problems & Foot Ulcers in Singapore