For many diabetes patients, amputation becomes a last-resort measure after infections, ulcers, or poor circulation worsen rapidly and leave few other treatment options.
But according to Dr. Estelle Everett, a physician and researcher specializing in endocrinology, diabetes, and metabolism at the
At the University of California, Los Angeles (UCLA), most diabetes-related amputations can be prevented through early intervention, consistent medical care, and patient education.
For Everett, her commitment to diabetes prevention is deeply personal. Watching her younger sister navigate Type 1 diabetes exposed her early to the challenges many patients face, including barriers to advanced diabetes technologies such as continuous glucose monitors and insulin pumps due to racial disparities in patient care.
Those experiences helped shape her focus on prevention, education, and equitable access to care.
Dr. Everett spoke with California Black Media (CBM) about the warning signs of diabetic complications, prevention strategies, healthcare access, and the role of diabetes technology in improving outcomes.
What are some of the early warning signs that a person with diabetes may be developing circulation and nerve problems that could potentially lead to amputation?
Amputation is usually the final stage of diabetic foot disease. Earlier signs often involve nerve damage. Some people experience numbness, tingling, burning, or loss of sensation in their feet.
Poor circulation is another warning sign. Symptoms can include calf pain with walking, foot pain at rest, cold feet, changes in skin color, or wounds that do not heal properly. Foot ulcers, thick calluses, and untreated cuts can also lead to serious infections that may eventually require amputation if not treated early.
Before complications reach that stage, what are some early signs of diabetes that people should look out for?
Many people are walking around with diabetes and do not even realize it. Some patients first seek medical care only after they’ve already developed complications because they’ve had diabetes for years without knowing it.
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.
Many Black Californians harbor a degree of distrust in the healthcare system. What message would you send to encourage people to get regular checkups?
Distrust is real, and there are many reasons people may avoid healthcare. Some fear discrimination or worry they’ll simply be judged instead of helped.
Personally, I realized some of the care my sister received may have been influenced by racial bias. Although she had diabetes for years, she was never offered diabetes technology like insulin pumps or continuous glucose monitors. When she finally asked about them, she was told she had to jump through many hoops.
Later, I realized her experience wasn’t unique. Research shows that minority patients and people from lower-income backgrounds are less likely to be offered diabetes technology. That inspired me to focus my research on improving access for the populations that need these tools the most.
I think building trust is important. 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 feel understands your concerns. That relationship can make a major difference in getting consistent care.
Are there newer technologies or innovations in diabetes care that people should know about?
One of the biggest advances has been continuous glucose monitors, or CGMs. These small wearable devices track blood sugar levels in real time and have really changed diabetes care over the past decade.
For providers, CGMs give a much clearer picture of blood sugar patterns throughout the day. For patients, they provide immediate feedback about how food, exercise, and other daily habits affect blood sugar levels.
Someone may notice that certain foods cause major spikes while certain exercises lower their blood sugar. That real-time information helps people make healthier decisions and improve blood sugar control. Research shows these technologies can significantly improve outcomes.
What daily habits or preventative measures can reduce the risk of complications or even amputation?
The biggest thing is controlling your diabetes. A lot of people automatically think diabetes will lead to amputations, but research shows the risk is much lower when diabetes is well managed.
That means taking medications as prescribed, making dietary changes, and working to keep your A1C below 7. Managing high blood pressure and high cholesterol is also important because both contribute to circulation problems.
People should also inspect their feet every day, especially if they’ve already lost sensation. Some patients injure their feet without realizing it because they can’t feel the damage. Catching wounds early is critical. Good foot hygiene also plays a major role in prevention.
Are there any common misconceptions about diabetes that stand out to you in your clinical work with Black patients?
One major misconception is that diabetes medications cause complications like kidney failure or amputations. In reality, poorly controlled diabetes causes those complications — not the medications used to treat it.
Those misconceptions sometimes cause patients to avoid medications or stop taking them altogether. Another issue is that some people believe diet and exercise alone should always control diabetes. While lifestyle changes are important, some patients have severe diabetes that also requires medication.
Needing medication is not a personal failure. Sometimes diet and exercise alone are simply not enough, and medication is necessary to prevent serious complications.
Video: Diabetes Is Killing Us Faster: The Alarming Reality for Black Californians
This article is supported by the California Health Care Foundation(CHCF). Visit www.chcf.org
Based on reporting by San Diego Voice & Viewpoint.
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