People with diabetes are at risk for many health problems to occur, including foot problems or amputation. When such problems occur, surgery may be needed to remove a limb or finger, such as a toe or finger.
However, there are steps that can be taken to keep the foot and leg healthy. In addition, even if your doctor recommends amputation, there are still steps you can take to protect your health and prevent future problems.
How does diabetes hurt the legs and feet?
Diabetes is associated with a condition called peripheral artery disease (PAD), which can narrow the arteries that transport blood to the legs and feet, making people more prone to wounds (open wounds) and infections, and also making wounds heal more slowly.
High blood sugar from diabetes can damage nerves and blood vessels in the body, including the feet and legs. If nerves are damaged, patients may not be able to feel pain or other wound or infection symptoms, which can then increase the risk of serious infection or gangrene, or tissue necrosis. In individual patients with severe disease, the only way for doctors to treat the infection or gangrene is to amputate the limb or remove the affected area.
Avoiding amputation
If you have diabetes, it’s important to take good care of your feet, which can reduce the risk of amputation.
Check your feet daily. Look for any abnormalities, such as:
- blisters;
- Cuts;
- cracking;
- wounds;
- redness;
- White spots or white patches;
- callus;
- Abnormal color.
If the foot is warmer or cooler than usual, this may also indicate some kind of abnormality. Sweep a feather or very light object along the foot to make sure the foot can sense its presence. If you are unable to check your foot, ask a family member to help. If you find an abnormal foot condition or are unsure if it is normal, consult your doctor.
Quit smoking. Smoking can damage small blood vessels and affect blood flow to the foot. It can also make it more difficult for physical injuries to heal. This can increase the risk of amputation.
Wear protective footwear. Injuries to the toes or feet can cause serious problems.
Visit your doctor at least once a year. If there is nerve damage, you may need to see a podiatrist or a diabetologist (endocrinologist) every month or two. Your doctor will help control your blood sugar with medication, diet and exercise, and will also examine your feet and legs to avoid any abnormalities. The earlier the trauma and other abnormalities are detected, the better the outcome.
What if the leg is amputated?
The doctor will first try to treat the infection or wound with medication. Doctors will not recommend amputation unless the tissue in the foot and leg is necrotizing or has already necrosed.
If surgery is really needed, the surgeon will remove the damaged tissue from the foot and leg and try to preserve as much normal tissue as possible.
After surgery, a two-week hospital stay is required. It was critical for the medical team to control blood sugar and watch for signs of infection.
It may take up to 2 months for the surgical site to heal completely. The patient will work with other professionals who will help adjust to life afterwards. For example, an endocrinologist can help manage blood sugar, a physical therapist can help get stronger and gradually learn to use the amputated limb for activities, and an occupational therapist will help adjust to daily tasks at home and at work.
It may also be necessary to go to a mental health therapist for counseling (such as a psychologist or social worker) and to talk about how you are feeling after the amputation.
Adherence to your doctor’s recommended diabetes treatment plan, strict monitoring of blood glucose and adherence to a healthy diet are critical.