When someone has diabetes, that puts them at a higher risk for developing many health-related problems. Some of these conditions include leg or foot amputations.
People with diabetes are prone to circulation issues and nerve damage that can lead to amputations. They often lose limbs due to ulcers or wounds that won’t heal properly.
Amputation can be avoided with appropriate therapy, so be sure to discuss alternatives with your provider before you undergo this procedure. You can find help with managing your condition through a Diabetes Wound Clinic. The number of these facilities has grown, and most health insurance plans cover treatment for patients in need.
Signs Of Diabetic Foot
People with diabetes have an increased risk of wounds that do not heal. This can potentially lead to necessary amputation, which is why daily foot checks can be the reason you can prevent this situation.
A person with diabetes should pay close attention to the following signs and symptoms:
- Open sores
- Athlete’s foot
- Active bleeding
- Plantar warts
- Swelling of the feet
- Ingrown toenails
- Skin discoloration
- Warmth in one area of the foot
- A bad odor emanating from a wound
- A deep ulcer where the bone can be seen
- An ulcer lasting more than a week
- A sore that you notice does not quickly begin to heal
- Ulcers larger than three-quarters of an inch
If you see any of these symptoms, you should talk to your doctor or medical care provider to determine which actions are recommended. Treatment options will vary, depending on the severity of the issue.
A person with diabetes must check their feet regularly to identify any potential issues as early as possible. The goal is to identify and treat the condition before it becomes severe. Awareness is key to being able to receive treatment in time.
To read more about all symptoms of diabetes, see my article about symptoms of diabetes.
Diabetes And Amputation
Lower Limb Amputation: How Common Is It?
A significant cause of lower limb amputation is diabetes. Globally, due to diabetes-related complications, a person loses a limb every 30 seconds, according to the American Diabetes Association.
The latest National Diabetes Statistics Report,( 2020) from the CDC provides the following insight:
- 34.2 million people, equivalent to 10.5% of the US population, have diabetes
- 88 million people over 18 are pre-diabetic of which;
- 24.2 million are over 65 years old
Based on the 2016 National Health Interview Survey. 130,000 adults had lower extremity amputations relating to diabetes. This figure is equal to 5.6 out of every 1,000 people with diabetes.
Lower Limb Amputation: Why Would It Be Necessary?
It is crucial to point out that not every person that has diabetes will require an amputation. Additionally, if someone with diabetes does need this procedure, chances are it is because of an ulcer or a wound on the lower leg or foot that did not heal properly.
Untreated wounds can lead to infection and gangrene (death of skin and/or tissue). A procedure known as debridement (removal of dead or decomposing tissue) is performed, If the dead tissue is not removed, gangrene will continue to spread.
Many times, people with diabetes have poor circulation, which can lead to peripheral artery disease (PAD). PAD causes a buildup of plaque in the arterial walls, and causes blockages to limbs and extremities. Extreme cases require amputation.
If a person has had an amputation and circulation problems continue, the blood flow does not go to the limb properly, and the surgical wound does not heal. In that case, further surgery may be indicated.
Lower Limb Amputation: How To Avoid It?
Proper Foot Care
A vital step to prevention of amputation is practicing proper foot care. This can be accomplished by performing the following actions:
- Schedule regular foot check-ups
- Wear shoes that fit correctly
- Avoid walking with bare feet
- Avoid calluses removal at home
- Trim toenails
- Control blood pressure, blood glucose, and cholesterol
- Quit smoking
- Wash your feet every day
- Wear dry socks
- Make sure that both feet can experience a variety of sensations, such as warm and cold temperatures
- Have another person help you examine the areas of the foot that are harder-to-see
- Wiggle the toes frequently , as this helps to stimulate blood flow
- Regularly examine the feet for any scrapes, blisters, bruises, and cuts
Aside from diabetes, other risk factors can increase the chances of a person requiring an amputation. Some of these include:
- Digestive and kidney diseases
- Peripheral artery disease (PAD).
- High blood pressure
- High blood sugar levels
- Vision impairment or other health issues with the eyes
- A history of foot problems or ulcers
- Abnormalities in the feet
- Nerve damage in the feet
- Corns or calluses
- Poor blood circulation to the extremities
- Any previous amputation
Blood Sugar Maintenance
There are various factors in our daily lifestyles that can help manage and control blood sugar levels. Some of these include:
- Regularly checking blood glucose levels
- Maintaining healthful blood pressure and weight
- Limiting sugary drinks and foods
- Maintaining a consistent schedule for meals and snacks
- Engaging in regular exercise
- Reducing stress
- Taking medications and insulin based on your provider’s recommendations
- See a Registered Dietitian to help create a well-balanced meal plan and stick to it
Lower Limb Amputation: What If It’s The Only Option?
Foot ulcer treatments can vary depending the severity of the wound. Generally speaking, the treatment uses methods to eliminate debris or dead tissue, keep the wound clean, and promote its healing. Wounds require frequent monitoring by a professional, sometimes up to two times per week.
Amputation could be the only option when health conditions result in a life-threatening infection or severe tissue loss. In these cases, a surgeon will remove the damaged tissue and will try to preserve as much healthy tissue as possible.
Following surgery, the amputee may be in the hospital for observation, and for rehab in order to help the wound to heal completely; it may take from four to six weeks.
In addition to the primary care provider, who regularly checks on diabetes, the surgeon and other medical field professionals are also involved in the treatment plan.
Let’s review this chart to see how each medical professional will play a role in the amputation process. Some of these providers may include:
|A mental health provider.||These include psychologists or psychiatrists. These medical health providers can help the patient address their feelings or expectations regarding the amputation process. They can also help the patient to cope with how other people may react to it.|
|A physical therapist.||This specialist will help the patient regain their balance, strength, and coordination. The physical therapist will also teach the patient how to use a wheelchair, an artificial (prosthetic) limb, or any other medical device required to improve the patient’s mobility.|
|An endocrinologist.||An endocrinologist is a physician that has special training in how to treat hormone-related disorders and diabetes.|
|An occupational therapist.||This therapist specializes in therapy to help improve daily skills. These include teaching the patient how to use adaptive products to help them do everyday activities.|
|A social worker.||A social worker provides assistance to help the patient access services and plan for changes in care.|
|A Diabetes Care and Education Specialist||This specialist works with you to develop a management plan that fits your lifestyle, beliefs, and culture, including a meal plan, an activity schedule, medication management and instruction, and mental health.|
|A Registered Dietitian||The dietitian will help create a nutrition plan that improves your health status and physical condition|
|A Diabetes Wound Care Nurse||The diabetic wound care nurse specializes in the treatment, care, and prevention of diabetic ulcers and wounds.|
Lower Limb Amputation: Life After Amputation
Even after amputation, it’s important to follow your diabetes treatment plan. People who’ve had one amputation have a higher risk of having another. Things that can help you prevent additional diabetes complications are:
- Avoiding tobacco
- Exercising regularly
- Eating healthful foods
- Controlling your blood sugar levels
- Controlling blood pressure
If you have diabetes, you will want to avoid wounds and sores. If an area of concern is left unattended, it can lead to infection. Infection can spread rapidly, and can spread to other areas of your body.
Pay close attention to your legs and feet, even if you have no current issues. Inspect your feet every day, and keep your diabetes under control.
Smoking and high blood sugar levels are factors that increase the risks of foot complications. These are things that you have the power to control.
Additionally, eating a balanced diet, participating in regular exercise, and maintaining a healthful weight, are all things that will help prevent amputation from ever becoming necessary.Diabetic foot ulcers are preventable, and prevention is key. Daily monitoring will keep you on top of things. If you see signs of redness, swelling, warmth or changes to your skin, contact your medical provider. Your feet will thank you in the ”long run.”