Amputation Prevention: Diabetic
People living with diabetes are at increased risk for developing foot problems. In the feet, diabetes can lead to nerve damage (neuropathy) and blood vessel damages. This in turn causes poor circulation, dry skin (xerosis), and decreased immunity to infection.
Initially with neuropathy, patient may experience tingling sensation which is worse at night. As the disease progresses, the pain may become so severe that it impacts patient’s ability to sleep. Overtime, the tingling sensation may progress to numbness. This sensation is often described as though the feet are “asleep” and feel “heavy”. The onset of numbness is concerning, because the patient may not detect any injury or irritation to the feet. Additionally, diabetes affects blood circulation in the lower extremity which may lead to wounds not healing, or healing very slowly. Since diabetes affect the immune system, a tiny cut can result in major infection.
Diabetes increases the risk of developing a wide range of foot problems. A small foot problem can turn into serious complications
Diabetes-related lower extremity problems
What your Foot and ankle Surgeons can do?
Foot and ankle doctors can help wounds heal and prevent amputation. There are many non-surgical and surgical options available to prevent limb loss. Regular foot checkups and seeking immediate medical attention when you notice foot irregularities are instrumental in preventing wounds and limb losses.
Your proactive measures
Please follow the listed guidelines if you notice any problems:
Inspect your feet daily: if your eyesight is poor, have someone perform the inspection.
Even with prompt care and treatment of infections, there are situations in which an amputation is necessary to save the limb or save a life
People living with diabetes are at increased risk for developing foot problems. In the feet, diabetes can lead to nerve damage (neuropathy) and blood vessel damages. This in turn causes poor circulation, dry skin (xerosis), and decreased immunity to infection.
Initially with neuropathy, patient may experience tingling sensation which is worse at night. As the disease progresses, the pain may become so severe that it impacts patient’s ability to sleep. Overtime, the tingling sensation may progress to numbness. This sensation is often described as though the feet are “asleep” and feel “heavy”. The onset of numbness is concerning, because the patient may not detect any injury or irritation to the feet. Additionally, diabetes affects blood circulation in the lower extremity which may lead to wounds not healing, or healing very slowly. Since diabetes affect the immune system, a tiny cut can result in major infection.
Diabetes increases the risk of developing a wide range of foot problems. A small foot problem can turn into serious complications
Diabetes-related lower extremity problems
- Infections and ulceration (sore): An ulcer, also known as a sore, is a break in the skin. This break in the skin is concerning as it can communicate and infect deeper structures like muscles, tendons, ligaments, and bones. Because diabetes affects the blood circulation and immune system, a small break in the skin or blister can communicate with deeper structures causing a deep infection. Infection can lead to loss of toes, feet, limbs and in some cases life.
- Corns and calluses: corns and calluses are thickening of the skin due to excessive pressure. These thickening of skin can lead to ulcer development.
- Dry, cracked skin (xerosis): Diabetes affects the glands that moisturize the skin leading it to dry skin. Dry skin can crack which can become sores and lead to infections.
- Nail disorders: ingrown toenails and fungal nails that are not managed properly can lead to infections
- Hammertoe and bunion deformity: any bony prominences can lead to an area of increased pressure and friction. Abnormal pressure when wearing tight shoes may lead to either corn/ callus production or a break in the skin. This may lead to an ulceration
- Charcot foot: this is a complex deformity which has a high risk of limb loss. For more information, please refer to Charcot foot section.
- Poor blood flow: the blood vessels below the knee can become narrow and resist blood flow because of diabetes. This can lead to tissue death also known as gangrene.
What your Foot and ankle Surgeons can do?
Foot and ankle doctors can help wounds heal and prevent amputation. There are many non-surgical and surgical options available to prevent limb loss. Regular foot checkups and seeking immediate medical attention when you notice foot irregularities are instrumental in preventing wounds and limb losses.
Your proactive measures
Please follow the listed guidelines if you notice any problems:
Inspect your feet daily: if your eyesight is poor, have someone perform the inspection.
- Skin or nail problems: look for any cuts, scrapes, redness, drainage, rash, discoloration of skin, loss of hair, and discoloration of toenails,
- Check for signs of swelling, redness, increase temperature, and swelling. Seek care immediately
- Do not ignore leg pain: pain that occurs at night with little activity could imply a blockage of an artery in the lower extremity. Seek care immediately
- Nail cutting: always cut your nails straight across
- No bathroom surgery: do not attempt to trim your own calluses or corns. Do not use any over the counter medicated pads for calluses and corns.
- Keep floor free of sharp objects
- Never walk on barefoot
- Check socks and shoes: Inspect shoes before wearing them. Make sure the socks are not bundled up
- Have your circulation and sensation checked by a doctor.
Even with prompt care and treatment of infections, there are situations in which an amputation is necessary to save the limb or save a life