People who have diabetes are at increased risk of lower leg amputation. The disease may diminish blood flow and sensation in their feet, and it may impair vision, so any wound is not readily apparent. Then because their immune system is compromised, their bodies struggle to fight any infection.

“If they don‘t have good blood supply to their foot, you can give all of the antibiotics that you want, but the antibiotics go in the blood, and the blood can‘t get to the foot. So therefore you have an untreated infection, and the patient can quickly lose the limb,” says Palma Shaw, MD, a vascular surgeon at Upstate University Hospital who specializes in limb salvage.

Tools at her disposal: improving blood flow through minimally invasive surgery, or through delicate open surgery in which veins are rerouted. If a wound has been festering for a month or more, she may have to surgically remove the wound or use an enzyme-based medication to stimulate healing.

More advanced options include hyperbaric oxygen and cell therapy.

Hopefully it never comes to that. Shaw urges people with diabetes to make regular visits to a podiatrist. She says monitoring foot health is as important as tracking sugar levels, blood pressure and kidney function.

Hear Dr. Shaw's interview on this topic on HealthLink on Air