Diabetes and amputation
It is an alarming statistic that 67 percent of lower limb amputations are a result of poorly controlled diabetes. People with diabetes are far more likely to have amputations of the lower limbs or legs. They may also suffer amputations of fingers, hands, or arms.
Many factors play in, with a large culprit being diabetic neuropathy. Damage to nerves that innervate the lower and upper extremities can contribute to deformities such as “Charcot’s foot,” creating a rocker bottom on the sole of the foot. Ulcers that are difficult to heal and progress to infection and gangrene can start with a simple tack in the foot, or a mild injury.
Other factors that play into the high prevalence of diabetic amputations include skin conditions that cause skin breakdown. When combined with poor circulation and PVD (Peripheral Vascular Disease), skin conditions lead to decreased healing, infections, subsequent gangrene and amputation if untreated.
In addition, those with diabetes can get calluses, warts, and other problems that can lead to an amputation if they try over-the-counter remedies or try “bathroom surgery” on themselves, attempting to dig out ingrown toenails and the like. Smoking certainly plays a factor, and serves as a double “whammy” for those with diabetes, as the displacement of oxygen from the bloodstream due to nicotine further complicates poor circulation. High blood sugars over time (uncontrolled diabetes) leads to non-healing ulcers, and subsequent gangrenous wound bed requiring amputation.
An amputation severely decreases a person’s quality of life, while also shortening their life expectancy. The life expectancy after an amputation is around five years.
Simple prevention measures
What can you do to prevent problems with your extremities that could lead to an amputation? For starters, checking your feet every single day of your life when you have diabetes. Report anything unusual about your feet to your healthcare provider.
Wash your feet with mild soap and warm water. Have someone check the bath water for you if you have neuropathy, so that you don’t burn your feet. Dry your feet and use a lotion without alcohol. There are many diabetic formulas available on the market that contain no alcohol. Do not apply lotion between your toes. Do not use over-the-counter wart or corn remover liquid or pads. These can eat a hole in your skin, as they have acid in them.
See a podiatrist before you develop problems with your feet or circulation so that the podiatrist sees you at baseline. Return for check-ups every year, leaving callus, wart, and thickened toenails to the professional to remove or trim. At every doctor’s visit, take off your shoes and socks so that your healthcare provider can check your feet!
Text: The Diabetes Council - 09/2017
To find out more, please go to The Diabetes Council