Amputation Prevention Alliance

Every 3 minutes and 30 seconds in the United States, <br>a limb is amputated due to diabetes.

Bare feet in the sand from above

Amputations are on the rise in the United States. There were over 154,000 diabetes-related amputations that took place in the United States last year—a 75% increase in just a decade. Diabetes is the single greatest factor in amputations—more than 60% of non-traumatic lower limb amputations happen in the diabetes population. An individual who has had an amputation has a worse chance of five-year survival than someone with coronary artery disease, breast cancer, and colorectal cancer. 

Amputations in the United States are also substantially more prevalent among people of color. Quite simply, whether or not you have a limb amputated can come down to the color of your skin, how much money you make, and where you live.

Amputation inequities and race infographic

Amputation Prevention Alliance

To address this crisis, the American Diabetes Association (ADA) has established the Amputation Prevention Alliance in partnership with innovators, clinical experts, leading health foundations, leaders in the diabetes community, policymakers, and provider groups. Our mission is to disrupt the curve of amputations among low-income and minority individuals with diabetes.  


<h3>The Amputation Prevention Alliance is focused on saving limbs and lives, including among communities facing disproportionately high rates of amputations and amputated-related mortality. This work will include advancing needed policy changes, driving clinician awareness of opportunities to prevent amputations, and empowering patients to advocate for their best care.</h3>

More amputation-related information

What is Peripheral Artery Disease?

People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. People with diabetes are far more likely to have a foot or leg amputated than people without diabetes. Foot problems most often happen when there is nerve damage, also called neuropathy. This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot, so you can injure it and not know it. Poor blood flow or changes in the shape of your feet or toes may also cause problems. Many people with diabetes have peripheral artery disease (PAD) (which reduces blood flow to the feet) and neuropathy. Together, these problems make it easy to get ulcers and infections that may lead to amputation. 

Diabetes and Your Feet

Most amputations are preventable by checking your feet daily, going to regular visits with your doctor, and wearing proper footwear.

The connection between diabetes and your feet is important because diabetes can cause nerve damage and reduced circulation, ultimately leading to limb loss and other complications. The good news is, you can lower your chances of complications by managing your blood glucose (blood sugar) levels and taking care of your feet.

For these reasons, take good care of your feet and see your doctor right away if you see any signs of foot problems. Ask about prescription shoes that are covered by Medicare and other insurance. Always follow your doctor’s advice when caring for ulcers or other foot problems.

Foot Check Tips and Techniques
  • Wash your feet thoroughly everyday
  • Dry them thoroughly, and don’t forget to dry between your toes
  • Moisturize your feet, but avoid moisturizing between your toes 
  • Keep your toenails trim and use an emery board to file down sharp edges
  • Check your feet for sores, cuts, blisters, corns, or redness daily. Let your doctor know if you find any of these. 
  • Wear moisture-wicking socks 
  • Before putting your shoes on, check for sharp objects (i.e., small rocks) 
  • Wear shoes that fit well and don’t rub your feet
  • While you’re at it, avoid these:
    • Walking around barefoot
    • Soaking your feet
    • Smoking
Therapies for Foot Wounds and Foot-Related Abbreviations

Read the ADA Clinical Compendia Series: New Evidence-Based Therapies for Complex Diabetic Foot Wounds

Below is a list of abbreviations used in the compendia:

  • ADA American Diabetes Association
  • ATA Absolute atmosphere
  • CDO Continuous delivery of oxygen
  • COVID-19 Coronavirus disease 2019
  • D Day
  • DFO Deferoxamine
  • DFU Diabetic foot ulcer
  • FDA U.S. Food and Drug Administration
  • HBOT Hyperbaric oxygen therapy
  • HIF-1α Hypoxia-inducible factor 1α
  • ITT Intention-to-treat
  • IWGDF International Working Group of the Diabetic Foot
  • M Month
  • MMP Matrix metalloproteinase
  • NOSF Nano-oligosaccharide
  • NPWT Negative pressure wound therapy
  • OR Odds ratio
  • PAD Peripheral artery disease
  • PDGF Platelet-derived growth factor
  • PO2 Partial pressure of oxygen
  • RCT Randomized controlled trial
  • RWD Real-world data
  • RWE Real-world evidence
  • TBI Toe-brachial index
  • TcPO2 Transcutaneous oxygen pressure
  • TLC Technology lipido-colloid
  • TOT Topical oxygen therapy
  • UT University of Texas
  • UTAUT Unified Theory of Acceptance and Use of Technology
  • VEGF Vascular endothelial growth factor
  • W Week


AOTI’s unique, multi-modality topical wound oxygen (TWO2) therapy has been proven in both random controlled trial and in real world evidence studies<sup>1</sup> to provide more sustained healing for diabetic foot ulcers, resulting in a six-time lower recurrence rate vs standard of care alone and 71% reduction in amputations over 12 months. TWO2 therapy can be administered by the patient at home, improving access to care and enhancing treatment compliance.

<sup>1</sup>A Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers; Robert G. Frykberg, Peter J. Franks, et al. The TWO2 Study; <em>Diabetes Care</em> 2020;43:616-624, <a href=""></a>.
Advanced Oxygen Therapy Inc logo


Issues surrounding equitable access to high-quality, preventive care in America are pervasive. At Podimetrics, we’re working tirelessly to address this fact for patients living with complex diabetes. It’s our belief that many of the access problems we’re seeing today for patients can be improved through three specific changes: 1) Broader expansion of patient care into the home, 2) Increased utilization of easy-to-use technology in the home that can help identify health care issues before they’re full blown costly health ailments, and 3) High-touch care that is focused on building a trusted relationship between a patient and their care team.
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