Table 1 Inclusion and exclusion criteria

Participants who are willing and have capacity to give informed consent.

People who have received a transplant and others receiving immunosuppressant therapy or using long-term oral glucocorticoids other than in the routine management of glucocorticoid deficiency. Participants on a low dose of oral glucocorticoids (< 10 mg for ≤ 7 days) are eligible to participate in the study.

People with diabetes as diagnosed by the WHO criteria http://www.who.int/diabetes/publications/diagnosis_diabetes2011/en/

Participation in another intervention study on active CN.

Age 18 years or over.

Contra-indication for MRI.

New or suspected diagnosis of acute CN (no previous incidence of acute CN within the last 6 months on the same foot) treated with off-loading.

Treatment for previous suspected CN on the same foot in the last 6 months.

Understand written and verbal instructions in English.

Suspected or confirmed bilateral active CN at presentation.

Active osteomyelitis at randomisation.

Previous contralateral major amputation.

Inability to have an MRI scan.

People receiving palliative care.