Amputations are a complication that many diabetic patients face. Learn more about the measures patients should take to prevent amputations.
Diabetes is a scary disease. Patients also have to worry about the health of their pancreas, eyes, kidneys and their legs and feet. And, they also have to worry about insulin injections and how they plan their daily routine around what they can and cannot eat.
One side of diabetes that is often talked about is nerve damage and poor circulation, which can lead to some serious leg and foot problems. This is called neuropathy, when the nerves in hands and feet are damaged leading to weakness, numbness, and even chronic pain. When neuropathy occurs, people have to pay close attention to their limbs, especially since they will not feel when they have an injury. Poor circulation is when blood flow is hampered by weak veins, injury or other reasons makes those limbs (affected by neuropathy) difficult to heal and ultimately, prevent infection.
For diabetics, even the most common and simplest injuries to a limb can lead to serious life-threatening infections. Over time, that infection can lead to the devastation of amputation. Some of the more common problems that diabetics face are:
- Dry skin: Who hasn’t had to deal with dry, cracked heels, especially during the winter months? Diabetics who aren’t careful can easily develop this problem. Poor circulation can make it almost impossible to heal, leaving the patient extremely vulnerable to infection.
- Ulcers: Ulcers are sore to the skin that doesn’t heal. They may start as blisters or small cuts. Eventually, poor circulation and numbness caused by nerve damage will help those small injuries grow until they reach the bone. Ulcers are incredibly dangerous and painful.
- Corns and callus hammer toes and bunions: When fashion wins, those incredibly cute but completely impractical shoes become a staple in a wardrobe. Diabetics who can’t feel the pinch from those shoes might not be aware that corns and callous are developing. Without treatment, those can eventually lead to more dangerous ulcers.
- Charcot's foot: This extreme and complex foot problem happens when a broken bone goes unnoticed and the patient keeps on walking on it leading to more issues. This often happens because nerve damage makes it impossible for the patient to feel that they have actually injured themselves.
How to stay protected?
The short answer to this question is: take care of your feet. Diabetics should make foot care part of their daily routine.
- Keep nails trimmed and neat. This prevents the occurrence of ingrown toenails and other issues that might pop-up. Regular pedicures are an option (and a nice treat too!) but, it’s essential to make sure that the spa is impeccably clean and tools are sterilized to prevent infection. Best bet would be to find a spa that specializes in pedicure for those with diabetes and other foot issues
- Don’t do it yourself. If there is any risk at all for infection, trying to trim calluses or corns with over the counter products at home is a big no-no. Always seek out professionals for this sort of thing.
- Inspect feet and legs daily. Be on the lookout for any changes in skin color, cuts, scraps, redness, swelling, rash, injuries and pretty much anything else that looks abnormal.
- Beware of leg pain, especially when it occurs at night or after doing simple activities like slow walking. If this occurs with no explanation, call a doctor immediately. The pain could be caused by a blocked artery.
- Always wear shoes or slippers. As tempting as it may be to walk barefoot in the sand, it’s safe to err on the side of cautious to avoid any possible injuries.
- Wash feet daily. Every day take a few minutes to wash your feet with lukewarm water and soap. After the feet are squeaky clean, dry them carefully, taking extra time to make sure that all moisture is removed, especially between the toes. Sprinkle talcum powder to prevent moisture from building up and slip-on a pair of clean dry socks (that have been inspected for anything that might scratch the skin). Aside from feeling wonderful, your feet will be less likely to contract infection if kept clean.
Other preventative measures:
- Always buy proper fitting shoes. Take the time to get your feet properly measured to avoid any shoes that could cause blisters or other issues. Try to wear moisture wicking socks and avoid getting feet wet or excessive sweating, if possible.
- Always have your feet tested. Every doctor's visit should include simple tests to make sure that feeling has been lost and that blood is circulating at it should.
- Don’t or stop smoking. Smoking has a negative impact on circulation and lowers the amount of oxygen that makes it into the bloodstream. Poor circulation can lead to more severe open sores that leave the patient prone to infection.
- Manage diabetes with a proper diet, regularly monitored blood sugar levels and the use of insulin or other medication
What happens if a problem occurs?
If there is any sign of problems, it’s critical to get prompt medical care. If caught and treated early, the chance of the ulcers developing is significantly lowered. As much as 80% of amputations started off with an ulcer, it’s important to do everything possible to avoid ulcers from developing.
Unfortunately, there are times that amputation is the only option. This is especially true when the patient begins to experience life-threatening infection or the tissue around the ulcer dying. A specialized surgical team will keep as much healthy tissue as possible before removing anything that may be damaged. After an amputation, the patient will be required to stay in the hospital for a few days before being discharged with a specialized post-operative care plan. It can take anywhere from four to six weeks to heal from surgery.
The specialized care might include treatment from a number of medical professionals including:
- Social worker and mental health provider. To help deal with the emotional trauma of undergoing an amputation. Social workers will also help to navigate a number of resources and support options
- A physical and occupational therapist. Depending on the severity of the amputation, physical therapy might be required to heal from surgery. Following that, an occupational therapist will teach the patient tips and tricks they need to live a normal independent life.
- Endocrinologist. These are doctors who specialize in helping patients treat their diabetes.
What happens after an amputation?
Even after undergoing an amputation, it’s critical that diabetics take the time to treat and manage their disease as much as possible. Diabetics who have undergone an amputation because of their disease are at a higher risk of needing another one at a later day. Maintain and follow a healthy eating plan and do everything possible to control blood sugar levels.
Facing the reality of the diabetes
There is no doubt that diabetes is a scary disease. Add in the higher risk for life-altering surgery like amputation, well that puts in a whole different category of scary. It’s important to remember though, that there are many things that patients can do to avoid amputation. Managing diabetes and blood sugar levels aside, by simply taking good care of their feet, knowing their bodies and paying attention to any changes in symptoms can make a difference between losing a toe, foot or part of a leg and living a long active full life with the disease.