How is Diabetes related to amputation?

How is Diabetes related to amputation?

In these situations, to ensure that infections don’t spread, or that dead tissue doesn’t contaminate other cells, an amputation is necessary. It is possible to prevent this, though, with focus and discipline on both treatment and lifestyle.

The most common amputations resulting from Diabetes symptoms involve the lower legs. This is caused by peripheral artery disease (PAD), one of the dangers of Diabetes. If you’re affected by PAD, your blood vessels narrow and your blood flow to your legs and feet becomes compromised. Without regular movement, such as cycling, swimming, running or similar, the result is nerve damage, known medically as peripheral neuropathy.

Prevention is better than minor surgery

Even if neuropathy occurs, preventing an amputation is possible. Light wounds or sores may develop on the skin’s surface, especially from the knee area further down toward the toes. If you’re losing feeling completely you’ll be unable to feel the pain associated with ulcers so make sure you check your legs and feet regularly. Report anything unusual to your doctor, nurse or clinic sister.

In advanced cases, ulcers may not heal. This is what leads to infection and septicaemia. Practicing good foot hygiene is critical:

• Try not to wear a single pair of socks for more than 12 hours.
• Shower in slops at the gym or spa to avoid athlete’s foot and other fungal infections.
• Wear appropriate footwear for a specific activity, like hiking or working on construction sites.
• Try not to walk around with bare feet for extended periods of time.
• Wiggle your toes frequently at your desk or while watching TV, to stimulate blood circulation.
• Clip your nails regularly, and manage ingrown nails or treat yourself to a pedicure once in a while.
• Practice regular inspections of your nails and skin and report anything unusual to your medical practitioner immediately.

Other lifestyle factors can help manage Diabetes and prevent amputation:

• Cope with stress regularly through a variety of activities.
• Eat well-balanced meals.
• Move more, even if you just do 10 laps around your dining table before each meal.
• Stick to your treatment plan.
• Discipline yourself to check your blood glucose levels at regular intervals, as guided by your medical practitioner.

Warning signs

Keep an eye on your body and monitor yourself for: 

• swelling in the feet
• blisters
• ingrown toenails
• plantar warts
• open sores
• athlete’s foot
• an ulcer that lasts more than a week
• pain
• active bleeding
• redness
• temperature differences across your legs and feet
• a deep ulcer where the bone is visible
• discolouration of the skin
• a bad odour from a wound
• ulcers larger than three-quarters of an inch
• a sore that does not quickly begin to heal.

If any of these symptoms are present, speak to your doctor. Your treatment will depend on how severe your symptoms are.

When is amputation necessary?

Not everyone with Diabetes will need an amputation of somet type. If required, it is likely to be due to a wound or ulcer that did not heal on the foot or lower leg. Medical teams across the world are also trained on how to remove as little tissue as possible, so as not to further affect patients.

If the surgery wound doesn’t heal, or blood flow to the limbs is not restored, surgeons may discuss a need to remove more tissue.

Stats about diabetes and amputation

Every country’s statistics differ. These figures are a global average for you to gain insight but don’t take this for granted. Always keep your medical practitioner updated and keep a pocket journal of notes to report at your next check-up.

• A 2012 study found that foot ulcers occur in 4–10% of people with Diabetes. When foot ulcers do occur, the majority have a good outlook:
  • 60–80% of foot ulcers will heal
  • 10–15% will remain active
  • 5–24% will eventually lead to limb amputation within 6–18 months of the initial evaluation.

Sources:

Fletcher, J. 2019. What to know about diabetes and amputation. Medical News Today. 3 April. Available at: https://www.medicalnewstoday.com/articles/324875.php [Accessed 5 August 2019].

McDermott, A. 2016. Why is foot care important if you have diabetes?. Healthline. 11 August. Available at: https://www.healthline.com/health/diabetes/diabetes-amputation [Accessed 5 August 2019].

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