Diabetic Amputation & Neuropathy — Is It Inevitable?

Diabetic Amputation
Diabetic neuropathy — nerve damage caused by high blood glucose levels — affects between 60 percent and 70 percent of individuals with diabetes. If you have it, your diabetic amputation risk will be higher. In fact, more than 50 percent of all amputations annually are associated with diabetes.

According to the National Institutes of Health, approximately 86,000 people undergo foot amputations yearly. But, you can reduce your likelihood if you understand the role neuropathy frequently plays in amputations.

How Neuropathy Causes Problems

The nerve damage and reduced sensations in your feet make it far easier for you to sustain injuries and get infections. Because you can’t notice any discomfort, ulcers, infections, and gangrene can develop easily, and poor circulation makes it harder for you to heal.

If the infection can’t be controlled or the wound won’t heal, amputation is a likely outcome to remove dead tissue. Of the roughly 15 percent of all diabetics who develop a foot ulcer, 24 percent will face amputation.

In some cases only toes or parts of the foot are removed to salvage as much healthy tissues as possible. But, if the infection has spread, doctors might have to remove the entire foot or leg. Amputations require several nights in the hospital and up to 8 weeks of recovery time. Prostheses, assistive devices, and home adaptations can help with rehabilitation.

Ways to Reduce Risk for Diabetic Amputation & Neuropathy

You can reduce your chances for developing an injury that ends in amputation.  Following these suggestions can help keep your feet in tact:

  1. Don’t smoke. It constricts the blood vessels, decreasing circulation.
  2. Get routine foot check-ups. Examine your feet daily, using a mirror to see them if needed. Have a medical provider check them regularly, as well.
  3. Control your blood sugar. Keep your levels between 70-130 mg/dL before eating and under 180 mg/dL after meals.
  4. Eat healthy. Choose lean meats, fruits, vegetables, fiber, and whole grains. Avoid sugared juices and sodas.
  5. Get at least 30 minutes daily. Swimming and walking are good options.
  6. Practice good foot care. Wash and dry your feet thoroughly every day, putting cornstarch between your toes to minimize moisture. Keep your toenails trimmed short. Apply a thin layer of petroleum jelly to your feet to reduce cracking. And, wear well-fitting, closed-toe shoes and dry socks without elastic at all times.
  7. Don’t remove warts or callouses with scrapers or scissors. It can leave your feet open to infection.
  8. Keep moving. Wiggle your toes and twist your ankles several times a day.

 

When to Talk With Your Doctor

Even if you follow these tips, problems could still arise. See your doctor if you have any of these issues: fungal infections, splinters, ingrown toenails, corns, bunions, callouses, plantar warts, chilblains, hammertoes, dry skin, gout, and heal pain/spurs.

Although diabetic neuropathy greatly increases your likelihood for foot injury and possible amputation, following these steps can give you the greatest chance for avoiding this surgery.

Contact the Amputation Prevention Centers of America for more information on diabetic amputation and neuropathy.

Living with – and Limiting – Diabetic Neuropathy

Diabetic Neuropathy
Diabetic neuropathy is nerve damage that causes numbness in your extremities and it has no cure. The good news is you can limit how much it impacts your body and life. Work with your doctor to secure a proper diagnosis and outline an effective treatment plan.

What will your doctor do if you have diabetic neuropathy?

Your doctor will ask about your symptoms and medical history, as well as check your heart rate, blood pressure and muscle tone. He or she will also check your reflexes, mainly in your ankles. A tuning fork test will determine sensitivity in your feet to vibration and a nylon fiber pinprick tests sensitivity to touch.

What are your treatment options?

Proper treatment can slow progression. There are several things you can do.

  • Medication: Discuss available medications with your doctor, including alternative therapies. Some medications can ease neuropathic pain by 30 percent to 50 percent. In some cases, alternative therapies, such as acupuncture, can alleviate symptoms when combined with medication.
  • Diet: Eating smaller meals improves digestion. Limit fiber and fat, concentrating mainly on fruits, vegetables, low-fat dairy, whole grains and moderate amounts of fish, poultry and nuts. Eat only small amounts of red meat.
  • Blood Sugar: Keeping your blood sugar in a healthy range (lower than 130 mg/dL before eating, lower than 180 mg/dL after eating) and maintaining a hemoglobin A1C of less than 7 percent can reduce nerve damage by up to 60 percent, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
  • Exercise: Strive for 30 minutes of exercise five days a week. Biking, walking, swimming, running and aerobics are good options to improve circulation to your arms, legs, hands and feet.
  • Get warm: Take a warm bath. It can boost your circulation.
  • Vitamins: Vitamin D can protect you against nerve pain. Getting enough on your own is difficult, so add a supplement to reach the 600-800 IU you need daily. Recent research revealed enough Vitamin D reduces neuropathy symptoms within two months. Low B12 also causes nerve damage and low B6 can decrease the chemicals in your body responsible for sending messages. Have your doctor check your levels.
  • Capsaicin cream: Hot peppers might make you think about having a spicy mouth, but the chemical ingredient that causes that sensation — capsaicin — can also alleviate the burning and pain associated with nerve damage. In fact, a study published in the journal Pain showed wearing an 8-percent capsaicin patch reduced pain by 30 percent after two weeks. Only your doctor can prescribe a higher-level cream, but even a 0.1-percent cream can provide up to 11-percent relief.

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Overall, since there’s no cure, you can’t completely alleviate the symptoms associated with your diabetic neuropathy. But, with proper treatment — and consultation with your doctor — you can significantly reduce how much it impacts your quality of life.

If you have any additional questions about diabetic neuropathy, contact the Amputation Prevention Centers of America.