By Mazizi Njokweni B-Tech (Podiatry) MSc Podiatry Candidate
DOI: 10.56885/040931vlppwo
Abstract: Diabetes-related foot disease (DFD) remains one of the most common causes of non-traumatic lower-limb amputations worldwide, with the most significant impact in low- and middle-income countries (LMICs). In South Africa, rising diabetes rates, coupled with strained health systems, hinder early detection, coordinated care and limb preservation. Although global research confirms that many diabetes-related amputations can be prevented, public health-care settings continue to experience high rates of avoidable limb loss. This article presents a conceptual Amputation Prevention Protocol (APP), developed from practical experience in a public regional hospital in Gauteng Province, South Africa and informed by global and LMIC-specific literature reviews. Rather than prescribing a rigid clinical pathway, the APP serves as a flexible decision-making and coordination tool to address key systemic issues, including the late detection of peripheral artery disease (PAD), fragmented referral processes and delayed involvement of multidisciplinary teams. This manuscript outlines the APP’s rationale, core components and intended use. It promotes early risk screening, accessible vascular assessments, podiatry-led coordination and team-based care, all tailored to resource-limited settings.