For people living with diabetes, foot complications can lead to serious consequences—including lower limb amputation. DAC is working alongside leading researchers and healthcare teams to change that reality by improving access to timely foot care for those most at risk.

With funding from Ontario Health, Dr. Charles de Mestral and Patient Partner Tom Weisz are leading an innovative Lower Limb Preservation project, integrating hospital and community-based care in partnership with the Downtown East Toronto Ontario Health Team (OHT) and Anishnawbe Health’s chiropody program. This initiative ensures that inner-city populations, including Indigenous clients, receive the foot care they need to prevent severe complications.

Taking this a step further, de Mestral, in collaboration with the GEMINI medicine research group and the Vector Institute for Artificial Intelligence, has developed an AI algorithm to identify patients with diabetes at highest risk of lower limb amputation. Application of this risk calculator to information on persons with diabetes admitted to St. Michael’s hospital,  Unity Health, individuals who need specialized follow-up after discharged are connected with community-based foot care.

Understanding the barriers to foot care is just as critical as providing it. Dr. Valeria Rac conducted a study interviewing patients and healthcare providers to uncover the challenges faced by structurally underserved communities in accessing diabetic foot care. The insights gained have directly shaped a new Lower Limb Preservation program at the University Health Network (UHN) and the Mid-West Toronto OHT, ensuring that Indigenous health and social services are integrated into care delivery.

What started at St. Michael’s Hospital is now spreading to UHN, with more sites expected to adopt this model across Ontario. These patient-centered initiatives are demonstrating how person-centered, integrated care can prevent unnecessary amputations, improve quality of life, and reduce the burden on the healthcare system. By turning research into action, DAC is driving meaningful change for those most at risk for diabetes complications.