I sympathize with your plight as well as your brothers misfortune. it sounds however like your brothers focus has been on himself for far to long. One of the basic human needs and a driving force for many people is need to feel significant. There are many ways of attracting attention from others in order to satisfy that need. His negative choices as you say began long before the amputation of his lower leg and may have contributed to his diabetes in the first place. Your brother has a overwhelming victim mentality and as long as it continues to serve his needs he will continue to play that role.

This is the EGO minds job… feed and protect itself. If deep below the surface your brother see’s himself as a loser, victim, failure it is likely he will continue to live that reality while still finding more and more creative ways to satisfy the ego’s need for significance.

This is a very tough situation for you to be in although you will grow as a result – however you can’t simply give up on him but you cannot also continue to feed his emotional need. If you have taken responsibility for him, provide for him and do for him many of the things he could, with some effort, do for himself, and continue to fruitlessly encourage him with motivational “bullshit” (as he may see it) you yourself may be enabling him to stay right where he is.

I would encourage you to do less for him and allow, even force him to take responsibility for his own situation and life. You don’t need to tell him “that’s it I’m done” or anything like that – just simply stop. This will require you to be stronger perhaps than you have ever been but if you truly wish to serve you brother it may be required of you. You can do this by focusing your attention and efforts on the people who not only need your help but want it.

Keep in mind that victims often become the victimize-rs. In order for that to not happen you need to make sure you do not become a victim of your brothers own self pity.

Oh, there are two other very basic human needs that can be even more powerful a driving force than significance – LOVE and the power of PRAYER… the two things you will never stop providing.