Diabetes is a major terminal disease, and it’s estimated that 422 million people are living with diabetes in the world, representing a prevalence of 8.5%. In 2016, the WHO reported that diabetes was the seventh leading cause of death in the world. The prevalence of diabetes has been rising more rapidly in middle-and-low-income countries attributed to lifestyle choices. Diabetes comes with significant complications, including neuropathy, retinopathy, kidney disease, and heart disease. People with diabetes are also at increased risk of foot or leg amputation. In fact, diabetes was established to be the leading cause of amputation of the lower limbs throughout the world.

The reason for increased risk of amputation among diabetes patients is due to the complications brought about by diabetes, including neuropathy, circulation issues, foot ulcers, and Charcot’s foot, among other problems. When diabetes patients develop neuropathy due to reduced blood flow to the feet, they lose the sense of feeling in their foot; therefore, they are unlikely to notice wounds or cuts which get infected and become severe necessitating amputation. In some instances, diabetes leads to the development of peripheral artery disease (PAD), which is characterized by the buildup of fatty deposits in the arteries causing reduced blood flow to the lower limbs. Poor blood supply to the lower limbs significantly slows down the rate of wound healing, reduces the effectiveness of the body to fight infections and increases the chances of gangrene (tissue death) due to reduced oxygen supply. Sometimes, such infections may not be treated, or the tissues/nerves damages reversed or stopped from spreading hence the need for amputation.

Nonetheless, amputations can be prevented with proper diabetes management, foot care, wound care, and access to the essential diabetes medical supplies. Better diabetes management has seen the reduction of lower limb amputations by half over the last 20 years.