Most of us can hardly imagine what it’s like to live with an amputated foot, hand, leg, or arm. It’s an unthinkable obstacle in a world that seems to require full mobility, and few of us are aware of how far prosthetics have come to ensure that amputees live life as normally as possible. But it’s a risk that many diabetics know they must endure. How often must diabetics undergo amputation, and why is it done?

Peripheral artery disease (or PAD) is a disease in which the blood vessels narrow or constrict, causing a dangerous reduction in blood flow to a person’s lower extremities. Over time the loss of blood flow can lead to nerve damage, and that means you might have a harder time sensing pain or discomfort. This is why a diabetic’s feet and legs are at risk for amputation, and it’s why diabetics should be sure to check their feet every single day.

If you don’t check, you might not realize there’s a problem. PAD doesn’t just prevent you from feeling pain, it actually reduces the rate at which a wound will heal. When this happens, infections become more common. As you age, these dangerous infections can lead to gangrene. If the infection enters the bone, you’ve got a big problem.

People with diabetes are often prone to several types of amputation: toes, feet, and legs. When age and PAD are factors in the decision to amputate, one can become many. Doctors see case after case in which a patient has his or her toes amputated only to then lose a foot or a lower leg because the infection could not be stopped.

There are a number of ways you can mitigate the threat of amputation while living with diabetes.

Start with the right kind of diet: consume only lean meats, fruits, and veggies. Be sure to get enough fiber. Do NOT drink soda or eat foods that have been sweetened. Exercise regularly and cope with stress immediately when it arises. If you’re overweight, work with a diabetic educator to help eliminate risk factors. Check your blood sugar routinely, and take insulin as required.

Above all else, be sure to keep checking your feet for signs of injury or infection! You might spare yourself from amputation-or even save your own life.