Diabetes related complications: Nontraumatic amputations


Persons with diabetes are at higher risk for foot problems. These foot problems may occur due to impaired circulation, often resulting from uncontrolled/poorly controlled glucose levels. Blood vessels in the feet may become inflamed, narrowed and hardened. Blood flow slows down, skin becomes dry and cracked and nerve endings are damaged; these changes can delay healing of injured or damaged skin and result in infection. As nerves are damaged, the usual sensations of discomfort, pain, or simply that something is wrong, may not occur. If you don’t feel pain in your feet, you may not notice a cut, blister, sore, or other problem. Left untreated, life threatening infections may occur that result in a medically necessary amputation.

Nontraumatic (meaning no actual trauma or injury has occurred) amputations occur more often in persons with diabetes more so than the general population. According to AJMC, (https://www.ajmc.com/newsroom/diabetic-amputations-may-be-rising-in-the-united-states)”...In the United States, every 17 seconds someone is diagnosed with diabetes, and everyday 230 Americans with diabetes will suffer an amputation. Throughout the world, it is estimated that every 30 seconds a leg is amputated. And 85% of these amputations were the result of a diabetic foot ulcer.” Quality of life is adversely affected, with a higher rate of mortality and a shortened life expectancy.

The good news is that most nontraumatic amputations are preventable with regular care and proper footwear. The following are general guidelines of proper foot care, including routine medical care as well as lifestyle changes (self-care practices) to lower your risk of foot injury/infection.

  • Keep your blood glucose levels within the target range as discussed with your medical provider.

  • Check your feet every day for areas of redness, blisters, cuts, calluses, or signs of infection. Have your medical providers check your feet at every visit.

  • Wash your feet every day; wear clean socks; avoid going barefoot.

  • Keep your skin smooth; use lotion daily (but not between your toes); keep toenails well-trimmed.

  • Inspect your shoes for normal wear and tear; check lining of shoes for any small objects (pebbles) before putting them on.

  • Protect your feet from exposure to extremes in temperature (too hot/too cold).

  • Stop smoking. Cigarette smoking constricts blood vessels and reduces blood flow, further increasing the risk of poor healing to injured tissue area.

For additional information on diabetes and foot care, check out these websites:

https://www.cdc.gov/features/diabetesfoothealth/index.html

http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html

https://professional.diabetes.org/abstract/amputation-prevention-diabetic-patients

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