Amputations due to diabetes can be prevented by taking proper care
Diabetes patients who take a minute or two every day to inspect their feet and observe a few simple rules can help themselves avoid having a foot amputation.
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Take precautions
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Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:
• Keep blood sugar under control to help minimize cardiovascular and blood circulation problems • Lose weight, don’t smoke and adhere to prescribed dietary, medication and exercise regimen • At least once a day, examine feet for cuts and other small wounds that aren’t necessarily felt • Never walk barefoot - outdoors and indoors • Cut nails carefully – straight across and not too short; never trim corns and calluses personally • Wash feet every day in lukewarm water; dry carefully, especially between toes • Choose comfortable shoes with adequate room for the toes • Wear clean, dry, nonbulky socks; change daily • Shake pebbles or bits of gravel out of shoes before wearing • Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don’t seem to be healing |
“Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions,” said Claire Capobianco, DPM, AACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). “Even those with good control of their blood sugar can experience foot ulcers and wounds, especially if neuropathy - a frequent diabetes complication - has caused decreased feeling on the bottom of their feet.”
Loss of sensation inhibits the body’s normal pain response. As a result, wounds in diabetic patients often don’t hurt and are not noticed. Even regular activities of daily life, such as walking, can cause repetitive, unfelt pressure to a wound, which can cause it to become larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.
Capobianco said foot and ankle surgeons use a variety of surgical and nonsurgical methods to heal diabetic ulcers, but she stressed early intervention yields the most favorable outcomes.
“Daily self exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that, over time, will ulcerate and become infected,” she said. “If you have diabetes and see anything suspicious on your feet, don’t wait to consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing.”
The statistics are sobering. An estimated seven in 10 diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, said Capobianco, prevents foot loss.
In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can’t improve blood circulation and foot function, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.
For more information on diabetic foot conditions, contact Capobianco’s office at Orthopaedic Associates of Southern Delaware, 302-644-3980, or visit foothealthfacts.org
