Chances are, soon after you were diagnosed with diabetes someone told you about scary complications that might develop: heart and kidney problems, vision loss, even amputation. Amputation? What does that have to do with your blood sugar?

Most people with diabetes will never be faced with amputation, but it is far too common in patients with poor diabetes control. Here’s why amputation is sometimes necessary, and simple steps you can take now to help avoid it.

If blood sugar levels are too high for a long time, nerve damage and other body problems may develop, usually over a period of years. The nerve damage, called diabetic neuropathy, may leave your feet unable to feel pain, and that sets the stage for trouble as small cuts, blisters, or sores may go unnoticed.

How does a simple foot sore lead to amputation?

Stepping on a bit of sharp glass or getting a blister from new shoes is no big deal for most people. We clean it, slap on a plastic bandage, and soon it heals. But without the ability to sense pain, people with diabetic neuropathy could literally step on a tack and keep right on walking, oblivious.

All people with diabetes are more likely to get infections, and may have a reduced ability to heal wounds. If your feet are numb due to neuropathy, a neglected foot injury – however small – may easily become infected and keep getting worse without you knowing it. An open wound or ulcer may develop that goes all the way down to the bone. Tissue around it may die. The infection can spread, becoming painful and life threatening. If medical treatments fail to stop it, doctors have no choice but to remove the affected area – a toe, part or all of the foot, or even a leg.

Sooner or later, about two out of three people with diabetes will develop some degree of neuropathy. And about one in seven diabetics will develop a foot ulcer at some point, though most cases will not lead to amputation. Foot ulcers are the most common reason that someone with diabetes is hospitalized. Early treatment of all foot injuries is key to preventing serious problems.

The good news

There’s a lot you can do to help preserve foot health and cut your risk of foot ulcers and amputation. Start now to make these tips part of your routine.

• Check your feet every day for signs of neuropathy and sores. This article explains how. If it’s hard to see the bottoms of your feet, set a mirror on the floor.
• Aggressively control your blood sugar with diet, medicine, exercise and other measures. recommended by your doctor. Uncontrolled diabetes often leads to neuropathy and other complications.
• Get regular foot checkups at least once a year, and let your doctor know about any cuts, splits, or other foot issues right away.
• Quit smoking. It’s linked to diabetic foot problems and may hamper blood circulation.

In addition, these steps can help if you already have numbness in your feet:

• Wear well-fitting, comfortable shoes. Watch for signs of friction or pressure that could cause blisters or other problems.
• Don’t walk barefoot.
• Be extra careful to avoid injuring surrounding skin when cutting your toenails. Consider having a foot doctor do it. Leave corn or callus removal to the doctor too.

No one wants to find themself facing amputation. Estimates suggest that about half of all diabetic foot amputations could be prevented with proper foot care. By acting now, you can tip the odds in your favor of having healthy feet for a lifetime.

To learn more about this topic:

Caring for Your Feet with Diabetes
Doctor Discussion Guide: Talking to Your Doctor about Neuropathy
Three Neuropathy-Friendly Exercises to Try