Amputation and diabetes: How to protect your feet

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Amputation and diabetes: How to protect your feet
MayoClinic.com

Amputation is a frightening concept. If you have diabetes, here's what you need to know about amputation — and how to avoid it.
Amputation is a frightening concept. And if you have diabetes, the risk of losing a toe or foot to amputation may be more real than you think. An estimated 5 percent of adults who have diabetes eventually require toe or foot amputation. Here's what you need to know about the link between amputation and diabetes — and how to keep your feet healthy.

Why does diabetes pose a risk of amputation?
Amputation and diabetes might seem like an odd pair. After all, what does amputation have to do with diabetes? Plenty!

High blood sugar can damage the nerves in your feet. Eventually, you may lose feeling in your feet. You could have a cut, blister or other minor foot injury and not know it. If the injury heals on its own, there's no cause for concern. But diabetes can also damage your blood vessels, leading to poor circulation in your feet. If you smoke, the damage may be even worse. This lack of blood flow may hinder your body's ability to heal foot sores or other injuries. Left untreated, a minor foot injury could become a serious infection — even leading to tissue death (gangrene). Severe damage might require toe, foot or even leg amputation.

How can amputation be prevented?
To prevent diabetes complications, make a commitment to managing your diabetes. Eat healthy foods, include physical activity in your daily routine and keep your blood sugar under control. Then put your best foot forward with these simple foot-care tips:

Wash your feet every day. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.
Inspect your feet every day. Check your feet for blisters, cuts, sores, redness or swelling once a day. If you have trouble bending over, use a hand mirror to see the bottoms of your feet or ask someone to help you.
Trim your toenails carefully. Trim your nails straight across. If you have any nail problems or poor feeling in your feet, ask your doctor about professional nail trimming.
Don't go barefoot. Protect your feet with comfortable socks and shoes, even indoors. Make sure new shoes fit well, too. Even a single blister can lead to an infection that won't heal.
Don't smoke or use other types of tobacco. Smoking reduces blood flow to your feet. Talk to your doctor about ways to quit smoking or to stop using other types of tobacco.
Schedule regular foot checkups. Your doctor can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Your doctor may refer you to a foot specialist (podiatrist).
Take foot injuries seriously. Contact your doctor if you have a sore or other foot problem that doesn't begin to heal within a few days. Your doctor may prescribe antibiotics to treat an infection. In other cases, infected tissue may be drained or removed. Sometimes surgery is needed to remove infected bone or increase blood flow to the affected area. Keep in mind that these wounds can take weeks or even months to heal.
What if amputation is the only option?
If an infection has progressed too far or becomes life-threatening, an amputation may be the only option. The surgeon will remove the damaged tissue, being careful to preserve as much healthy tissue as possible. After surgery, you'll be monitored in the hospital for a number of days. It may take four to eight weeks for your wound to heal completely. Emotional acceptance of the amputation may take time, too.

While you're recovering from surgery, your rehabilitation team — which might include a physical therapist, occupational therapist, social worker and other health professionals — will help you adjust to life after amputation. You may be fitted for an artificial limb and learn exercises to strengthen the affected area. You may learn how to use assistive devices and adapt your home, if needed, to help you resume your usual activities. If you experience pain in the amputated limb (phantom pain), you'll learn techniques to deal with the discomfort.

Even after amputation, remember that it's important to follow your diabetes treatment plan. Eating healthy foods, exercising regularly, controlling your blood sugar level and avoiding tobacco can help you prevent additional diabetes complications. If you're having trouble accepting the amputation or how it's changed your life, share your feelings with friends, loved ones or other close contacts. If necessary, contact a mental health professional for additional support.