EVERY week in Australia about 70 people undergo a diabetes-related amputation.
"The cost is around $25,000 for an amputation, then $8000 every year after that to the health system," Dr Peta Tehan, a podiatrist and researcher based at the University of Newcastle, said.
"But the biggest problem is that after someone undergoes a major amputation, their risk of death is around 50 per cent within five years.
"They don't survive it a lot of the time because they tend to be quite sick and have a lot of co-morbidities."
Dr Tehan said it costs more than $600 million a year to care for people with diabetic foot ulceration - a largely preventable problem with the appropriate care and support.
The cost is around $25,000 for an amputation, then $8000 every year after that to the health system.Podiatrist Dr Peta Tehan
"A loss of sensation, or a loss of blood flow, and then a wound that becomes infected - they are the three main things that really predict amputation," she said.
"If we can know about those and try our best to manage them, hopefully we can avoid amputation."
According to Diabetic Foot Australia's 2018-2022 national strategy, public hospital admissions, lower extremity amputations and deaths caused by diabetes-related foot disease cost the Australian health system an estimated $1.6 billion a year.
Dr Tehan and her team of researchers are exploring new ways to test blood flow in feet to help diagnose issues earlier.
"What we want is for people with diabetes to not develop the loss of sensation or the arterial disease in the first place, which is complicated," she said.
"Ideally, you need to have really good blood glucose control to prevent those complications from occurring. Control your weight, have a good diet, control your blood pressure and cholesterol.
"It is a lot to ask, and diabetes is complicated and lifelong. There is no holiday and people are human.
"But it is when the spikes in blood glucose are ongoing and prolonged that we see those complications occurring."
Dr Tehan explained that diabetes affected multiple organ systems, including feet, which most of us take for granted.
"The problem sometimes is if people with diabetes lose that ability to sense their feet, that gift of pain is lost, so they don't know there is a problem," she said.
"That's where preventative strategies like checking your feet daily and having regular visits to the podiatrist and good footwear can help protect and make sure these complications don't occur.
"If we don't know it's there, we can't treat it. Treatment is normally things like exercise, and managing their cardiovascular risk factors - blood pressure and cholesterol, and looking at their diet."
But people with a diabetes diagnosis need not fear they were going to lose their feet.
"The majority of people with diabetes never experience a foot ulcer, for instance," Dr Tehan said.
"It's a small number who do, but that number is far too high because it's preventable. Footwear is one of the biggest causes of foot ulceration."
A study into the diet quality of people with foot ulcerations found those who had been living with diabetes for more than 20 years had not seen a dietitian or diabetes educator since their diagnosis.
"So, they are not using these services that could help improve their blood glucose control, which is contributing to the development of foot ulceration," Dr Tehan said.
"It's a missed opportunity. I think as health practitioners we need to be better equipped at managing behaviour changes and engaging with patients and enabling them to make good decisions.
"And patients need to know where they can go and get support at the right time."