Diabetes, Ulcers and Amputation
How Diabetes Affects Feet
People with diabetes are more susceptible to foot problems, often because of two complications of the disease: nerve damage (neuropathy) and poor circulation. Peripheral neuropathy causes a loss of feeling in the feet, reducing the ability to feel pain or injury. Poor circulation diminishes the body’s ability to heal, making it difficult to resist infection and heal injuries or wounds.
For a person with diabetes, these complications can be a deadly combination. When a person with diabetes has neuropathy, they often cannot tell if their shoes are causing pressure and producing corns, calluses, cuts or blisters. These minor foot injuries can develop into ulcers, which is a break or hole in the skin. If poor circulation is also present, the ulcers can become infected and may not heal properly. This is a common complication associated with diabetes and can lead to a chronic foot ulcer, which is a leading cause of amputation. Amputation is considered when healing potential is poor or a serious infection becomes wide-spread, threatening the patient’s life.
It is vital for diabetics to take preventive measures to care for their feet, including wearing proper shoes, daily foot inspections and regular exams by a foot and ankle surgeon. Because even the smallest foot problem can turn into serious complications, it is important to seek treatment early for any issues, especially minor cuts, blisters and corns and calluses.
When Complications Arise
The loss of life and limb are real concerns for diabetics with a serious infection. Physicians and patients work together to consider the best options to treat the infection, prevent limb loss and to get the patient well as soon as possible.
When Amputation is the Best Course of Treatment
Amputation is a complication that both patients and physicians work to avoid if possible. It is estimated that nearly 85 percent of amputations are preventable with education and early intervention. Amputation should not always be seen as a failure of treatment but instead as a faster, more reliable means of rehabilitation in order to return to activities of daily living. Surgery may be the best way to control a severe infection that could require a more traumatic amputation in the future or that could otherwise prove fatal for the patient. After undergoing an amputation, patients often experience improved general health because a severe infection has been resolved.
Amputations do not always mean loss of the entire foot or leg. Surgical intervention is performed at many levels including partial toe amputations, partial foot amputations or below the knee amputations. A foot and ankle surgeon will make a thorough assessment and determine the best method of getting the patient on the road to recovery.