Hyperspectral Imaging to Assess and Predict Diabetic Foot Ulcers

Ulcer Healing Study Inclusion Criteria: * Subjects with Type 1 diabetes (defined as diabetes beginning before age 35, requiring insulin, and diagnosed with diabetes for more than six months) or Type 2 diabetes. * Presence of at least one foot ulcer Exclusion criteria: * Peripheral arterial occlusive disease (PAD) that is severe enough to require surgical bypass operation. * Cardiovascular disease as demonstrated in only these instances: congestive heart failure that leads to severe edema at the lower extremity, stroke or transient ischemic attack with residual nerve dysfunction. * Uncontrolled hypertension: SBP\>190 mmHg or DBP \> 110 mmHg * End stage renal disease (subjects on renal dialysis or kidney transplantation) * Any other serious chronic disease that can affect wound healing * Subjects currently on any of the following medications: Glucocorticoids, Antineoplastics * Females if lactating or pregnant or, if of childbearing potential, unwilling to use standard birth control. All females of childbearing potential will undergo a pregnancy test during each visit. NEW ULCER PREDICTION STUDY: Inclusion criteria: * Subjects with Type 1 diabetes (defined as diabetes beginning before age 35, requiring insulin, and diagnosed with diabetes for more than six months) or Type 2 diabetes. * Subject without foot ulcers but at "high risk" for foot ulceration. In order to define "high risk" for this study, we are using the International Working Group standards: 1. Advanced neuropathy, defined by loss of protective sensation in the foot with a vibrational perception threshold (VPT) over 25mHz or inability to detect Semmes Weinstein 5.07 (10g) monofilament 2. Presence of significant deformity 3. Peripheral vascular disease with ankle brachial index \< 0.7 4. History of previous ulceration or presence of a foot ulcer 5. At least one foot that is ulcer free at the time of enrollment Exclusion criteria: * Peripheral arterial occlusive disease (PAD) that is severe enough to require surgical bypass operation. * Cardiovascular disease as demonstrated in only these instances: congestive heart failure that leads to severe edema at the lower extremity, stroke or transient ischemic attack with residual nerve dysfunction. * Uncontrolled hypertension: SBP \> 190 mmHg or DBP \> 110 mmHg * End stage renal disease (subjects on renal dialysis or kidney transplantation) * Any other serious chronic disease that can affect wound healing * Subjects on any of the following medications: Glucocorticoids and Antineoplastic agents * Females if lactating or pregnant or, if of childbearing potential, unwilling to use standard birth control. All females of childbearing potential will undergo a pregnancy test during each visit.