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Diabetes complications can include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly.

The good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years.

When foot ulcers do develop, it's important to get prompt care. More than 80 percent of amputations begin with foot ulcers. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg.

Some people with diabetes are more at risk than others. Factors that lead to an increased risk of an amputation include:

• High blood sugar levels
• Smoking
• Nerve damage in the feet (peripheral neuropathy)
• Calluses or corns
• Foot deformities
• Poor blood circulation to the extremities (peripheral artery disease)
• A history of foot ulcers
• A past amputation
• Vision impairment
• Kidney disease
• High blood pressure, above 140/80 millimeters of mercury (mmHg)

Here's what you need to know to keep your feet healthy, the signs you need to see a doctor and what happens if amputation is necessary.