IT STARTED AS JUST A SMALL SORE ON HIS HEEL, nothing to worry too much about.

Twelve days later, the sore had worsened into a gangrene-infected ulcer. And soon after, diabetic Adan Monterrosa lay in a hospital bed, his left ankle and foot amputated.

"I had the thought that nothing would happen because it didn't bother me," Monterrosa, 46, of South-Central, said as he sat in his hospital bed on a recent afternoon at Rancho Los Amigos Hospital in Downey.

The loss of a limb is always horrible, but what makes Monterrosa's tale--and the stories of uncounted thousands of other diabetics like him--even more tragic is that it possibly could have been avoided.

In Central Los Angeles, minimal access to medical care and lack of awareness of the potentially serious consequences of unchecked diabetes is taking its toll on segments of the population already genetically predisposed to the disease.

With regular checkups, doctors can often catch early symptoms of diabetes that patients may overlook and can inform them of how to curb its progression. But because many do not have the means to get preventive care or wait too long before they do, diabetes among people of color is often more devastating than it needs to be.

Diabetes ranks high among illnesses affecting those in minority communities. Ranked as the third leading cause of death by disease, diabetes strikes people of color at an alarmingly high rate. Genetic makeup and environmental factors contribute to the extreme consequences of the disease among minorities, but poor diet, stress and sedentary lifestyles--all correctable, to some degree--exacerbate the problem.

"Historically, diabetes has been recognized as being in the majority population, with the insulin-dependent and kids," said Dr. Don Garcia of the Community Health Foundation of East Los Angeles' Bell office and a member of a statewide steering committee on treating diabetes at the local level. "But there has been a rude awakening that diabetes has changed. It is no longer just among Europeans and juveniles, but it is an ethnic disease that has besieged communities of color."

More than 14 million people nationwide have diabetes, half of whom are undiagnosed and most of whom are minorities, according to the American Diabetes Assn. The federal Centers for Disease Control estimates that Native Americans have diabetes at a rate five times greater than whites. The rate among Latinos and Asian Americans is three times greater than whites, and African Americans have a rate twice as high as whites.