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Diabetes Complications and Amputation Prevention

People living with diabetes are at an increased risk of developing foot problems, primarily due to two common diabetes-related complications: nerve damage, known as neuropathy, and poor circulation. Neuropathy can lead to a loss of sensation in the feet, making it challenging to detect pain or discomfort, which can prevent the timely identification of injuries or irritations. Poor circulation in the feet reduces the body’s ability to heal, making even minor cuts susceptible to infection.

Living with diabetes significantly heightens the risk of various foot problems, and these seemingly small issues can potentially escalate into severe complications.

Diabetes Complications and Amputation Prevention

Common Diabetes-Related Foot & Leg Problems:

  • Infections and ulcers: Neuropathy and poor circulation can lead to cuts or blisters turning into ulcers, which may become infected and resist healing. This is a prevalent and critical complication that could result in the loss of a foot, leg, or even a life.
  • Corns and calluses: Neuropathy may prevent the detection of pressure and friction from shoes, potentially causing corns and calluses, which must be appropriately treated to prevent ulcers.
  • Dry, cracked skin: Poor circulation and neuropathy can cause dry skin, which may lead to cracks that can become sores and eventually become infected.
  • Nail disorders: Ingrown toenails and fungal infections can go unnoticed due to the loss of feeling. If left untreated, they may lead to infections.
  • Hammertoes and bunions: Nerve damage can weaken foot muscles. Resulting in deformities like hammertoes and bunions, which, if untreated, may lead to ulcers.
  • Charcot foot: This complex deformity occurs due to the unnoticed fracture of a bone, often caused by neuropathy. The patient continues to walk on the broken bone, making it worse. In severe cases, surgery or amputation may be necessary.
  • Poor blood flow: In diabetes, blood vessels below the knee can narrow, restricting blood flow and impairing wound healing.

The Role of Your Foot & Ankle Surgeon:

Your foot and ankle surgeon can play a crucial role in preventing amputations by facilitating wound healing and employing advanced surgical techniques, such as joint reconstruction and wound healing technologies. Regular foot checkups and immediate attention to any issues can prevent minor problems from escalating. Your foot and ankle surgeon collaborates with other healthcare providers to prevent and manage diabetes-related complications.

Proactive Measures:

Take proactive measures to play a crucial role in minimizing complications. Refer to these guidelines and reach out to your foot and ankle surgeon if you observe any issues:

Daily Foot Inspection. Examine your feet every day. If your eyesight is compromised, enlist the help of someone else. Check for:

  • Skin or Nail Problems: Look out for cuts, scrapes, redness, discharge, swelling, unpleasant odor, rashes, discoloration, hair loss on toes, injuries, or changes in nail appearance (deformities, stripes, yellowing, discoloration, thickening, or slow growth).
  • Signs of Fracture: If your foot becomes swollen, red, hot, or undergoes changes in size, shape, or alignment, immediately consult your foot and ankle surgeon.
  • Leg Pain: Never disregard leg pain, especially if it occurs at night or with minimal activity, as it may indicate a blocked artery. Seek medical attention promptly.
  • Nail Care: If you experience nail issues or have difficulty feeling your feet, ensure that your toenails are trimmed correctly. Avoid attempting “bathroom surgery” or using over-the-counter medicated pads on calluses or corns.
  • Safe Environment: Keep your living spaces free from sharp objects. Confirm that no needles, insulin syringes, or other sharp items are left on the floor.
  • Footwear: Avoid going barefoot both indoors and outdoors. Always wear shoes to protect your feet.
  • Shoe and Sock Inspection: Before putting on your shoes. Shake them out, and make sure your socks are not bunched up.
  • Circulation and Sensation Assessment: Schedule regular assessments with your foot and ankle surgeon to evaluate your circulation and sensory perception. Ensuring you haven’t lost any feeling or blood flow.

When Is Amputation Necessary?

Despite preventive care and timely treatment, there may still be situations. Where amputation is necessary to remove infected tissue, save a limb, or even save a life.


Dr. Kris Dinucci