New York (CNN) - When Gina Keatley first moved to New York to attend culinary school, she noticed that many of her neighbors were missing limbs.
"I lived on 99th Street across from some projects," she said. "I would walk to the train and think, 'Why are there so many amputees?'"
Keatley found out that many of them had to have amputations because of complications from diabetes. Diabetes can reduce blood flow to extremities and cause nerve damage, and sometimes amputations are necessary if serious infection sets in and there is severe damage to the tissue and bone.
The neighborhood where Keatley lived, East Harlem, has the highest diabetes rate in Manhattan, according to city health officials. It also has the highest obesity rate: One-third of adult residents are obese or overweight.
"It's so shocking to me to see people who are poor and unhealthy and literally dying in the street," said Keatley, an award-winning chef and nutritionist.