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	Diabetic risk factors
	As is true with all diabetic complications, certain factors increase risk of foot problems. The greatest of these is smoking. According to the American Diabetes Association, of the people with diabetes who need amputations, almost all are smokers. Other high-risk factors include being male and being African-American or Native American. Risk increases with age, too.
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	Prevent foot problems
	The trick to treating and preventing foot problems lies in finding out ifs a blood vessel is about to become blocked. It used to be that doctors could locate blockages in large vessels, such as those of the legs, only by ordering an x-ray called an angiogram. Then they might perform bypass surgery to detour blood around the blockage. In this surgery, a piece of healthy vein is "harvested" from an area of the body (possibly the thigh) and is attached at either end of the obstruction. The new vein directs blood to cells that had been receiving an inadequate supply. It's one method of preventing gangrene-albeit an invasive and expensive one. There is now another way to prevent foot ulcers, gangrene, and amputation. A simple low-tech test can prevent at least 27,000 amputations of toes and feet a year (half the current annual total), according to the Lower Extremity Amputation Prevention (LEAP) program sponsored by the U.S. Department of Health and Human Services (HHS). The painless test is performed using a monofilament, a long, flexible nylon bristle. By pressing this calibrated nylon filament against each of ten predetermined places on the foot, your health care practitioner can determine whether you are losing sensation in your foot. If you are, you and your practitioner can take steps to keep foot ulcers from developing. And the test is (or should be) inexpensive: The reusable monofilaments are available for as little as $10 each. A monofilament test that people with diabetes can perform themselves is also being developed to serve as an adjunct to a test by a physician.
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	When Should I get tested?
	Because the rates of cardiovascular disease are so high in those with diabetes, the American Diabetes Association recommends and screening tests and intervention for heart disease for everyone with diabetes over age thirty.
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	Managing Complications
	People with diabetes are living longer, healthier lives than ever before. Research has provided more and better treatments for the various complications of diabetes. The longer someone lives with diabetes, however, the greater the chance of developing long-term complications.
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	Ask the Expert
	Our educators can answer only general inquiries -- meaning those that might be asked by the broad community of people with diabetes. Most often, these involve nutrition and a healthy lifestyle. If you have a more specific, individual concern -- especially one related to treatment -- please address it to your own healthcare team. We apologize if we are unable to
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	How Can I Keep My Blood Sugar at a Healthy Level?
	Eat about the same amounts of food each day. Eat your meals and snacks at about the same times each day. Do not skip meals or snacks. Take your medicines at the same times each day. Exercise at about the same times each day.
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