Whether it’s due to diabetes complications or a circulatory problem called peripheral arterial disease, black people are far more likely than their white counterparts to have all or part of a limb amputated, according to a new study.

Research from Northwestern University’s Feinberg School of Medicine suggests black people are five times more likely to have a foot or leg amputated because of one of these conditions than white people are. The researchers say this may be due to the fact that black communities suffer disproportionately from diabetes and other illnesses, or have less access to resources and treatments that would prevent them from requiring amputation.

Prevention is key in halting the progress of diseases like diabetes to a state where amputation becomes necessary. If you are diabetic, talk to your doctor about a plan for sticking to your medications, and establishing strict blood sugar monitoring.