Far too many diabetics in Canada are losing lower limbs to amputations and many of these surgeries could easily be prevented, say experts in the field.

Approximately 15 per cent of all people living with diabetes will be affected by a foot ulcer during their lifetime.

That's because the extra concentrations of glucose in their blood from their diabetes can damage their blood vessels and nerves, leading to a loss of circulation and sensation in their feet.

This damage can put their feet at increased risk of infection and ulcers, which if left untreated can lead to serious complications, such as gangrene and sepsis.

In fact, up to 85 per cent of all lower limb amputations among diabetics are preceded by a foot ulcer.

"I think it's really a tragedy that we have so many patients lose their feet," said Dr. Jay Silverberg, an endocrinologist.

"We have to educate diabetes patients to look at their feet, to look for signs of ulceration or that an infection is brewing."

Disturbingly, research shows that diabetics who have had one lower limb amputated have a 50 per cent mortality rate in the five years following the amputation.

As well, they have 50 per cent risk of developing a serious lesion in the second limb within two years, often leaving them immobile and putting them at risk of further complications from their diabetes.

"It is unacceptable that so much disability and death are caused by leg amputations, when the solutions are clear and affordable," says Dr. Catherine Le Galès-Camus, Assistant Director-General for Non-communicable Diseases and Mental Health with the World Health Organization.

"Small investments in prevention and education can mean fewer leg amputations, increased quality of life for individuals and dramatic reductions in health-care costs."

Doug Scott's story

Doug Scott is typical of a diabetic who is paying the price for ignoring a foot problem.

"When I was first diagnosed with Type 2 diabetes, I thought, oh I feel fine, there's nothing the matter with me. So you tend to ignore what the doctor says and what the ramifications might be."

In late August, he noticed a small "bruise" on his left foot but didn't think much of it. When the "bruise" began to spread, Scott soaked his foot in hot water, but didn't notice that he had scalded his foot badly, making matters worse.

Gangrene set in and Scott lost a couple of toes. Despite his best efforts, the problem only grew. Doctors said the only treatment is an amputation.

"Quite frankly, I'm scared. I certainly don't look forward to losing part of my leg," he told CTV News before his surgery.

While the surgery went well, another complication of diabetes hit Scott. He suffered a fatal heart attack days after the operation. His family wanted CTV to finish his story because it was what he would have wanted.

"People with diabetes need to take an active role in their own care," says Dr. Pierre Lefèbvre, the president of the International Diabetes Federation, "but they need to be supported by their health-care system to learn how to self-manage effectively."

The WHO notes that simple behaviours could prevent many foot problems. These include encouraging diabetics to:

• Perform regular foot examination,
• Not walk barefoot,
• Keep feet clean,
• Examine the inside of shoes before putting them on,
• Wear comfortable footwear, and
• Maintain good care of toenails

"Our message is that this can be serious. A small infection can lead to treatment this way (amputation)," said Dr. John Murnaghan, an amputation specialist at Sunnybrook and Women's Health Sciences.

"If I can contribute something to increase the awareness of this disease, I would say, 'You're not invincible. It can get you. it can get anybody who has diabetes'," said Doug Scott.

With a report from CTV's Avis Favaro