Abstract

Diabetes mellitus is a major global public health challenge and a leading cause of non-traumatic lower-extremity 
amputations worldwide. The burden of diabetes-related amputation is driven primarily by preventable 
complications, notably diabetic foot ulcers arising from neuropathy, peripheral arterial disease, infection, and 
impaired wound healing. This review examines the epidemiology, pathophysiology, risk factors, prevention 
strategies, and management approaches linking diabetes to lower-limb amputation. Emphasis is placed on early 
detection through neuropathy screening and vascular assessment, effective glycaemic control, patient education, 
appropriate footwear, and multidisciplinary care. The paper also explores wound management, advanced therapies 
such as revascularization, surgical decision-making, rehabilitation, and psychosocial support following amputation. 
In addition, health system and policy implications are discussed, particularly in low- and middle-income settings 
where resource limitations exacerbate outcomes. Despite advances in diagnostics and treatment, diabetes-related 
amputations remain common, underscoring the need for integrated prevention programs, standardized care 
protocols, and strengthened health systems. A coordinated, patient-centred, and multidisciplinary approach 
remains essential to reducing the incidence of diabetic foot complications and improving quality of life for affected 
individuals.