February 28, 2017
Avoiding Diabetes Amputations
Diabetes means that the risks for many problems are increased. Amputation of a foot or part of a leg can happen and these you want to avoid. Maintaining management of your blood glucose levels is important, but even more important is the daily inspection of your feet and legs to detect areas like foot ulcers, areas of infection, or areas not healing normally. This is why I see a podiatrist on a quarterly basis.
Diabetes is linked to a condition called peripheral artery disease (PAD). It can narrow the arteries that carry blood to your legs and feet and make you more likely to get ulcers (open sores) and infections. It also can make those things heal more slowly.
High blood sugar levels caused by diabetes can damage the nerves and blood vessels in your body. That includes the ones in your feet and legs. If your nerves are damaged, you might not feel pain or other symptoms of ulcers or infections. That raises your risk of serious infection or gangrene, which refers to the death of your tissue. In some severe cases, the only way doctors can treat the infection or gangrene is to amputate, or remove, the area that's affected.
If you have diabetes, it's especially important to take good care of your feet to lower your risk of amputation. Check your feet every day. Look for changes like – blisters, cuts, cracks, sores, redness, white spots or areas, thick calluses, and different colors.
If they're colder or warmer than usual, that can also be a sign something's wrong. Run a feather or light object along your foot to make sure you can feel it.
Neuropathy can also cause a lack of feeling in your feet and will mean a daily check of your feet for sores like ulcers. If you can't check your own feet, ask a family member to help you. If you notice a problem or aren't sure if something's normal, call your doctor.
Don't smoke: Smoking damages your small blood vessels and affects blood flow to your feet. It also makes it harder for your body to heal. Those things raise your risk of amputation.
Wear protective shoes: An injury to your toes or foot can lead to serious problems. Medicare and some other health insurance providers will cover prescription shoes that lower your risk of foot problems.
See your doctor at least once a year: If you have nerve damage, you may need to see a foot doctor (podiatrist) or your diabetes doctor (endocrinologist) as often as every month or two. He can help keep your blood sugar under control with medication, diet, and exercise. He'll also look at your feet and legs to make sure there's nothing wrong. The earlier you catch ulcers and other problems, the better.
Your doctor will try to treat infections or wounds with medicine first. He/she won't recommend amputation unless tissue in your foot or leg is dying or has died.
If you do need the operation, your surgeon will remove the damaged tissue on your foot or leg and try to save as much healthy tissue as possible.
You'll be in the hospital for up to 2 weeks after surgery. It's important for your medical team to keep your blood sugar under control and watch for signs of infection.
It may take 2 months for your wound to heal. You'll work with several people who will help you adjust to life afterward. For example, your endocrinologist can help you manage your blood sugar. A physical therapist can help you get stronger and learn to move around. An occupational therapist will help you figure out how to do everyday tasks at home and at work.
You also might see a mental health therapist, such as a psychologist or social worker, to talk through your feelings about your amputation.
It's important to stick to the diabetes treatment plan your doctor recommends, watch your blood sugar carefully, and eat healthfully.