It's a scary truth that individuals dealing with Type 1 or Type 2 diabetes face a higher risk of amputation. Diabetes-related amputation, which is a last-resort option, typically results from wounds on the feet and poor circulation. But as long as patients take preventative measures, they may be able to steer clear of this problem.

What is peripheral arterial disease (PAD)?

A condition that diabetic patients should be aware of is peripheral arterial disease, in which plaque builds up in the arteries and blocks blood flow, primarily in the legs. Plaque is made of fat, cholesterol, calcium, fibrous tissue and other substances in the blood. When plaque accumulates in the arteries, it may become a condition called atherosclerosis. Over time, plaque may harden and narrow the arteries, limiting the flow of oxygen-rich blood to organs and other parts of the body. When blood vessels can’t carry enough blood to the feet and legs, PAD may result.

People with PAD have an increased risk for diabetes complications such as heart attack and stroke. The numbers may be surprisingly high - an estimated 1 out of 3 people with diabetes over the age of 50 have this condition, according to the American Diabetes Association.

Warning signs of PAD

The tricky part of PAD is that some people who have it don't exhibit symptoms. Possible symptoms include:

• Leg pain, especially when walking or exercising, which disappears after a few minutes of rest
• Tingling, numbness or coldness in the lower legs
• Sores on feet or legs that heal slowly

Disparities between African Americans

A new report from the Dartmouth Atlas Project found that black Type 2 diabetes patients are three times more likely to lose a leg to amputation than non-black patients. That's in part because black patients are far less likely to get preventative care such as foot exams, blood sugar testing and cholesterol testing. These routine, smaller steps may help lower the risk.

For the report, researchers looked at Medicare claims from 2007-2011 of patients diagnosed with diabetes and peripheral arterial disease. They discovered that in the U.S., there is an average of 2.4 leg amputations for every 1,000 Medicare patients with diabetes. Regionally, those with the greatest chance live in Mississippi and West Virginia, tied for the two most obese states. These southern states have some of the highest amputation rates in the whole country.

"The resources needed to prevent amputation are currently severely misaligned," co-author Dr. Philip Goodney, director of the Center for the Evaluation of Surgical Care at Dartmouth Hitchcock Medical Center, told Time. "While we must look for opportunities to expand education and preventive care for all patients at risk for amputation, it seems clear to us that we can make the greatest gains by focusing on African-American patients in the highest-risk regions, typically in the poor rural regions of the Southern United States, where the highest amputation rates remain."

To learn more about the increased risk of amputation for diabetics:
Staying Informed as a Diabetic: Avoiding Amputations
Neuropathy: Why Is Amputation Sometimes Necessary?
Diabetic ‘Smart Socks’ May One Day Help Prevent Amputations