For many people living with diabetes, the thought of losing a foot or leg is among the disease’s most frightening complications. But according to Dr. Estelle Everett, an endocrinologist and diabetes researcher at the University of California, Los Angeles (UCLA), most diabetes-related amputations are preventable with early detection, proper treatment and consistent medical care.
Everett, who specializes in endocrinology, diabetes and metabolism, said amputations are typically the final stage of diabetic foot disease, often occurring only after infections, ulcers or poor circulation have gone untreated.
“Amputation is usually the final stage of diabetic foot disease,” Everett said. “Earlier signs often involve nerve damage.”
Those warning signs can include numbness, tingling, burning sensations or a loss of feeling in the feet. Poor circulation may also cause calf pain while walking, foot pain at rest, cold feet, changes in skin color or wounds that heal slowly. Untreated cuts, foot ulcers and thick calluses can become infected and, if left untreated, may ultimately require amputation.
Everett said one of the biggest challenges is that many people do not know they have diabetes until serious complications develop.
“Many people are walking around with diabetes and don’t even realize it,” she said. “That’s why routine screenings are so important. If you have diabetes, controlling it early can significantly reduce the risk of severe complications later on.”
Her commitment to diabetes prevention is also personal. Everett said watching her younger sister manage Type 1 diabetes opened her eyes to the barriers many patients face in receiving equitable care.
She recalled that despite living with diabetes for years, her sister was never offered newer technologies such as an insulin pump or a continuous glucose monitor (CGM). When she finally asked about them, Everett said, she encountered unnecessary obstacles.
“Later, I realized her experience wasn’t unique,” Everett said. “Research shows that minority patients and people from lower-income backgrounds are less likely to be offered diabetes technology.”
That realization helped shape Everett’s research, which focuses on improving access to diabetes care for underserved communities.
She also acknowledged that distrust of the healthcare system remains a barrier for many Black Americans seeking regular medical care.
“Some fear discrimination or worry they’ll simply be judged instead of helped,” Everett said. “Finding the right doctor is almost like dating. If you don’t feel comfortable with your provider, it may help to find someone you connect with and who understands your concerns.”
One of the most significant advances in diabetes care, Everett said, has been the widespread use of continuous glucose monitors. These small wearable devices measure blood sugar levels throughout the day, giving patients immediate feedback about how food, exercise and daily activities affect their glucose levels.
For physicians, the technology provides a more complete picture of a patient’s blood sugar patterns, allowing for more personalized treatment. For patients, it can help reinforce healthier habits by showing how lifestyle choices directly influence blood sugar.
Research has shown that continuous glucose monitors can improve diabetes management and reduce the risk of complications.
Everett emphasized that the most effective way to prevent serious complications is to keep diabetes under control. That includes taking prescribed medications, maintaining a healthy diet, staying physically active and working with a healthcare provider to keep A1C levels below seven percent whenever appropriate.
She also encouraged patients to manage high blood pressure and cholesterol, both of which contribute to poor circulation and increase the risk of foot problems.
Daily foot care is another critical step.
People with diabetes should inspect their feet every day, especially if they have already experienced numbness or loss of sensation. Because nerve damage can prevent patients from feeling cuts or injuries, small wounds can quickly become serious infections if they go unnoticed.
Everett also hopes to dispel a common misconception she frequently hears from patients.
“One major misconception is that diabetes medications cause complications like kidney failure or amputations,” she said. “In reality, poorly controlled diabetes causes those complications—not the medications used to treat it.”
She said that misunderstanding sometimes leads patients to stop taking medications that could help protect their long-term health.
“Needing medication is not a personal failure,” Everett said. “For many people, healthy eating and exercise are essential, but they’re not enough on their own. Medication can be necessary to prevent serious complications.”
Health experts estimate that millions of Americans are living with diabetes, and many more have pre-diabetes without knowing it. Physicians encourage adults (particularly those with a family history of diabetes or other risk factors) to receive regular screenings and seek medical attention early if symptoms develop.
