Diabetes-Related Amputation: Reduce Your Risk

The very idea of losing a limb, or part of one, is terrifying. Individuals who have diabetes are at a higher risk for amputation than others, and diabetes is a leading cause of amputation in the United States, says Spyros Mezitis, MD, of Lenox Hill Hospital in New York City. But if you take extra health precautions, it's preventable.

"Amputation usually becomes necessary when the person has developed severe nerve damage, called peripheral neuropathy," says Ronald Goldberg, MD, of the Diabetes Research Institute in Hollywood, Florida. With peripheral neuropathy, an individual loses sensation - often in the foot - so that if a cut or a callous occurs, he can't feel it.

"Gradually, an ulcer develops and an infection can spread until it reaches the bone," Goldberg says.

With peripheral neuropathy, it's all to easy to step on a sharp object and not realize something is in your foot, says Nicholas Morrissey, MD, associate professor of vascular surgery at Columbia University's School of Medicine in New York City. "You don't realize it until the wound gets infected," he says.

Poor circulation that makes the feet more vulnerable to ulcers also can put a person at risk for possible amputation.  "If you have an open wound and you have circulation problems, you run the risk of amputation," Morrissey says.

While amputation is indeed a frightening prospect, there are ways to avoid it. Here's how:

  • Keep your blood sugar as close to normal as possible. "There's evidence that if you control your sugar, vascular problems are less common," Morrissey says.
  • Keep you feet clean and dry, Mezitis advises.
  • Inspect your feet regularly for cuts or calluses. If you have a wound, don't assume that topical antibiotics will take care of it. See your doctor to make sure. And don't forget to look between your toes regularly to check for a fungal infection, Mezitis says.
  • If you smoke, stop. Smoking hinders circulation and keeps sufficient oxygen from getting to the blood.
  • Take steps to get your cholesterol in the normal level, and make every effort to keep your blood pressure in the normal range as well, Morrissey advises. When your cholesterol is high, it can have an adverse effect on the nerves, Goldberg says.
  • See a specialist such as a podiatrist on a regular basis for foot checks, Goldberg advises. "And the health care professional should have a high degree of suspicion," he says. "The person should take off shoes and socks so the health care professional gets a good look at his feet."
  • Wear cotton socks and comfortable shoes. (Yes, that means no five-inch stilettos!)
  • Keep an active lifestyle, Morrissey advises. This doesn't mean you must go out and run five miles a day. Instead, find a form of exercise you enjoy and you'll be more likely to stick with it.