Carolinas HealthCare System
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Losing Limbs to Amputation: A Potential Consequence of Diabetes
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With increasing numbers of Americans being diagnosed with Type 2 diabetes, more patients are also experiencing one of the disease’s most common complications: lower limb loss.

More than 65,700 people lose a toe, foot or leg each year due to diabetes – the most frequent cause of lower limb amputations not involving trauma, according to the American Diabetes Association.

But how does diabetes lead to amputation? Diabetes can cause several changes in the skin, nerves and blood vessels that create a “perfect storm” of problems leading to limb loss. These include:

  • Neuropathy: Diabetes can trigger nerve damage in the feet that lessens the ability to feel pain, heat and cold. This makes it difficult to feel if your foot is injured, allowing an infection to take hold. Nerve damage can also lead to changes in the shape of feet and toes, triggering pressure sores.
  • Peripheral artery disease: Diabetes can cause blood vessels in the leg and foot to narrow and harden, lessening blood flow to the limb. Poor circulation can hamper your foot’s ability to heal from an infection.
  • Calluses: A thick, hard buildup of skin occurs more often and builds up more quickly on the feet of those with diabetes. If not trimmed, these calluses can break down and turn into open sores known as ulcers.

Fighting Limb Loss

Despite these factors, people with diabetes can take many steps to avoid lower limb amputation. In fact, 85 percent of these amputations among people with diabetes can be avoided, according to the International Diabetes Foundation.

The first – and perhaps most important – step is performing daily foot checks to look for any signs of damage to the feet, including cuts, sores, blisters or ulcers. Even a small injury should be treated quickly and aggressively. If a sore doesn’t show signs of healing over several days, visit your healthcare provider.

Other self-care measures include:

  • Carefully monitoring and controlling blood sugar levels. High glucose levels make it difficult to fight infection.
  • Drying your feet and toes gently after bathing and sealing in moisture with a thin coat of plain petroleum jelly, unscented cream or similar products; however, avoid putting moisturizer between your toes.
  • Visiting your healthcare provider to trim or cut any calluses on your feet. Treating calluses yourself can lead to cuts and infection.
  • Walking only while wearing footwear, whether indoors or out. Never walk barefoot.