This study will evaluate the relationship between limb loss progression and changes seen in collagen metabolic markers in the diabetic Achilles tendon. This will be assessed by collecting Achilles tendon samples in subjects who are at various stages of ulcer development or limb loss and who also demonstrate an equinus deformity. All Achilles tendon samples will be collected at the time of the Achilles lengthening procedure. There will be five subject groups consisting of subjects who have been identified with: 1)preulcerative plantar foot lesion 2)plantar ulceration without a history of amputation or require an amputation 3) plantar ulceration who will be undergoing a digital amputation 4) plantar ulceration who will be undergoing a transmetatarsal amputation or 5) plantar ulceration who will be undergoing Chopart's or more proximal amputation. Further, systemic changes (vasculopathy, peripheral neuropathy, nephropathy) will also be correlated with the above. The independent variables are the following: 1) collagen metabolic markers and 2)systemic changes. The dependent variable is limb loss progression assessed categorically (5 groups).