Compass Fitness.com Diabetes Related Lower Extremity Amputation Prevention
According to the Centers for Disease Control and Prevention (CDC), diabetes is the leading cause of non-traumatic lower extremity amputations in adults age 20-74.The best way to prevent diabetes related lower extremity amputation is to closely monitor your blood glucose daily and follow your healthcare team’s prescribed therapies for your diabetes management including prescribed foot care treatment. Gaining a better understanding of the link between diabetes and the high risk of having a lower extremity amputation can empower diabetics to better manage their diabetes.
Non-traumatic lower extremity amputations are highly correlated to a condition of uncontrolled diabetes known as diabetic neuropathy. Diabetic neuropathy is damage to nerves resulting from diabetes. It is believed that the prolonged, elevated levels of blood glucose in uncontrolled diabetes is a primary cause of the nerve damage. There are different types of diabetic neuropathy. The type of diabetic neuropathy linked to non-traumatic lower extremity amputations is called peripheral neuropathy which can cause pain, tingling, burning and numbness of the feet and lower legs. The symptom of numbness is most linked to foot and below the knee amputations in diabetics because it can lead to sores or cuts on the foot and lower leg which are undetected and become infected.
In addition to peripheral neuropathy, many people with diabetes also have poor blood flow to the feet caused by a condition called peripheral arterial disease (PAD). With PAD the blood vessels of the foot and leg narrow and become hardened. The poor blood flow makes it more difficult to fight lower extremity infections.
Diabetes can also change the skin on the feet of diabetics. Diabetes can cause the foot skin to be dry and sometimes crack. In addition, diabetics get more calluses on their feet. If not trimmed, they can get very thick, break down and turn into ulcers.
With PAD and peripheral neuropathy,a sore or ulcer on the bottom of the foot can become severely infected and then infect the bones of the foot. An infection of the bone is called osteomyelitis. In the severest cases of osteomyelitis of the lower leg, the only treatment is amputation.
To prevent severe foot infections and the risk of amputation, diabetics need to take extra precautions with foot care. Recommended diabetes foot care includes:
Inspect your feet daily. Check the bottom of your feet for any bumps, swelling or sores.
Keep your skin soft and dry. Use a moisturizer on the tops and bottoms of your feet but NOT in between your toes.
Protect your feet from extremes of hot and cold exposure.
Promote circulation to your feet. Wiggle your ankles and toes two or three times a day and QUIT SMOKING if you smoke!
Take care of calluses-use a pumice stone on wet skin followed by lotion and have a healthcare provider trim or cut out calluses which are out of control.
Wash your feet daily and carefully dry them-especially between the toes.
If you are living with diabetes, you should closely monitor your blood glucose daily to help prevent prolonged periods of elevated blood glucose. You should comply with your healthcare team’s prescribed therapies to lower blood glucose when it is high-above 130 mg/dL Fasting and above 180 mg/dL after a meal.
