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In some cases, this can make a foot or lower leg amputation necessary. However, effective treatment can help prevent this complication. Reduced blood flow to the feet means that people with diabetes have a higher risk of developing a wound or sore on this part of the body. If a person has neuropathy and loses feeling in their foot, they may be less likely to notice mild foot or leg ulcers until they become severe. Due to circulation issues, particularly peripheral artery disease, these ulcers may not heal. This can lead to infection, tissue death, and potential lower limb loss. Although people with diabetes have an increased risk of needing an amputation, it is possible to help prevent most diabetes-related amputations by managing blood sugar levels, wearing suitable footwear, and taking good care of the feet. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. How common is it Share on PinterestPatrick Chu/Getty ImagesDiabetes is a significant cause of lower limb loss. According to the American Diabetes Association, worldwide, a person loses a limb due to diabetes-related complications every 30 seconds. A 2012 study found that foot ulcers affect 4–10% of people with diabetes. When foot ulcers do occur, the majority have a good outlook:60–80% of foot ulcers heal10–15% remain active5–24% eventually lead to limb amputation within 6–18 months of the initial evaluation According to the National Diabetes Statistics Report, 108,000 adults had lower extremity amputations relating to diabetes in 2014. This number equates to five out of every 1,000 people with diabetes. When is amputation necessary Not everyone with diabetes will need an amputation. If a person with diabetes does need this procedure, it is likely to be due to a wound or ulcer on the foot or lower leg that did not heal. In some cases, a doctor may also recommend an amputation to help prevent an infection from spreading. Most amputations are progressive, which means that a doctor will start by removing the smallest possible amount of tissue that is necessary. However, a person may need further surgery to remove more tissue if the wound does not heal or the limb does not have sufficient blood flow. Warning signs People living with diabetes should pay extra attention to their feet. This is because they have an increased risk of wounds not healing, which could lead to the need for an amputation. Some of the signs and symptoms that a person should look out for and contact their doctor about include:swelling in the feetblistersingrown toenailsplantar wartsopen soresathlete’s footan ulcer that lasts longer than a weekpainactive bleedingskin discolorationwarmth in one area of the foota deep ulcer where the bone is visiblea bad odor coming from a woundulcers larger than three-quarters of an incha sore that does not quickly begin to heal If any of these symptoms are present, a person should contact their doctor to determine a course of action. The treatment options will depend on how severe the symptoms are and what is causing the issues. It is important that a person examines their feet regularly to identify potential problems as early as possible. A doctor will aim to treat the issues before they become severe. Risk factors and how to avoid amputation There are several things a person can do to help prevent the need for limb amputation. Two particular areas to focus on are blood sugar maintenance and foot care. Blood sugar maintenance Several lifestyle factors can help a person manage their blood sugar level, including:reducing stressfollowing a balanced meal plan that a dietitian has helped createdoing regular exercisetaking medications and insulin according to a doctor’s recommendationsmaintaining a consistent meal and snack schedulelimiting sugary foods and drinksreaching or maintaining a weight and blood pressure that is healthy for themchecking their blood glucose level regularly Foot care Another important preventive step is to take good care of the feet, which a person can do by taking the following action:examining the feet regularly for cuts, bruises, blisters, and scrapeswiggling the toes frequently to stimulate blood flowhaving another person help examine areas of the foot that are harder to seewearing dry sockswashing the feet dailyregularly checking that the feet can feel cold and warm temperatures and various sensationsquitting smokingcarefully trimming the toenailsnot removing calluses at homeavoiding walking around barefootwearing well-fitting shoesscheduling regular foot examinations A 2020 review concluded that people with foot ulcers were more likely to need an amputation if they:were malehad a history of smokinghad a history of foot ulcershad osteomyelitis, a bone infectionhad gangrenehad a lower body mass indexhad a higher white blood cell count Having gangrene significantly increased a person’s risk of needing an amputation. Summary People living with diabetes have an increased risk of needing lower limb amputation. Wounds or ulcers that do not heal are the most common reason for amputation. Factors such as high blood sugar levels and smoking can increase the risk of foot-related complications, which can lead to a need for amputation. Ways of lowering the risk of needing an amputation include managing blood sugar levels through diet, exercise, and medicine, avoiding smoking, and taking care of the feet. People with diabetes should seek prompt treatment for any issues that affect their feet. Treating problems early may help a person avoid ulcers and infection, and this can reduce the risk of needing an amputation. Last medically reviewed on September 4, 2022DiabetesType 1Type 2Surgery 8 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Alexiadou, K., et al. (2012). Management of diabetic foot ulcers.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508111/Diabetes foot complications. (n.d.).https://diabetes.org/diabetes/foot-complicationsDiabetes. (2021).https://www.who.int/news-room/fact-sheets/detail/diabetesHoffstad, O., et al. (2015). Diabetes, lower-extremity amputation, and death.https://diabetesjournals.org/care/article/38/10/1852/37663/Diabetes-Lower-Extremity-Amputation-and-DeathLin, C., et al. (2020). Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A meta-analysis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494323/Murphy-Lavoie, H. M., et al. (2022). Diabetic foot infections.https://www.statpearls.com/ArticleLibrary/viewarticle/20441National diabetes statistics report, 2017: Estimates of diabetes and its burden in the United States. (2017).https://dev.diabetes.org/sites/default/files/2019-06/cdc-statistics-report-2017.pdfStatistics about diabetes. (2022).http://www.diabetes.org/diabetes-basics/statistics/FEEDBACK:Medically reviewed by Kelly Wood, MD — By Jenna Fletcher — Updated on September 4, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is the truth about type 2 diabetes?Medically reviewed by Maria S. Prelipcean, MD Many people have misconceptions about type 2 diabetes. 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