diabetestalk.net

What Causes Foot Amputation In Diabetics?

Amputation And Diabetes: How To Protect Your Feet

Amputation And Diabetes: How To Protect Your Feet

Good diabetes management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation. Diabetes complications can include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly. The good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years. When foot ulcers do develop, it's important to get prompt care. More than 80 percent of amputations begin with foot ulcers. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg. Some people with diabetes are more at risk than others. Factors that lead to an increased risk of an amputation include: High blood sugar levels Smoking Nerve damage in the feet (peripheral neuropathy) Calluses or corns Foot deformities Poor blood circulation to the extremities (peripheral artery disease) A history of foot ulcers A past amputation Vision impairment Kidney disease High blood pressure, above 140/80 millimeters of mercury (mmHg) Here's what you need to know to keep your feet healthy, the signs you need to see a doctor and what happens if amputation is necessary. Preventing foot ulcers The best strategy for preventing complications of diabetes — including foot ulcers — is proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring and adherence to a prescribed medication regimen. Proper foot care will help prevent problems with your feet and ensure prompt medical care when problems occur. Tips for proper foot care include the followin Continue reading >>

Diabetes: Protect Your Feet And Legs

Diabetes: Protect Your Feet And Legs

If you have diabetes, you are more likely than people without this disorder to develop leg and foot problems. Diabetes can destroy nerves and cause you to have poor circulation. Left unchecked, these complications can lead to amputation. But there's a lot you can do to prevent that from happening. How Diabetes Causes Limb Problems First, it's important to understand what causes these diabetes complications. According to Marilyn Tan, MD, an endocrinologist and the clinic chief of the Stanford Endocrine Clinic in California, risk factors include poor circulation from atherosclerotic peripheral arterial disease, poor wound healing, and uncontrolled blood sugar increases, which increases the risk of infection. “Think of sugar as fuel for bacteria and fungus,” says Dr. Tan. Researchers also know that high blood glucose levels can cause nerve damage called diabetic neuropathy. The damage can occur in any part of your body, but it is most common in your arms and legs, with the lower extremities affected first. This type of nerve damage is known as peripheral neuropathy. Some people have no symptoms, while others experience numbness, tingling, burning, sharp pain, cramps, extreme sensitivity when touched, and a loss of coordination and balance. When you have peripheral neuropathy, small sores can go unnoticed because of the numbness — you simply don’t feel them. Left untreated, these little problems can become major infections that invade the bones. What’s more, poor circulation from diabetes means any ulcers and infections are harder to heal. If an infection invades your bones, then amputation could be required to save your life. “Diabetes is the leading cause of nontraumatic lower extremity (leg and foot) amputations in the United States,” says Tan. “Five perc Continue reading >>

The Diabetic Foot And Risk: How To Prevent Losing Your Leg

The Diabetic Foot And Risk: How To Prevent Losing Your Leg

Anyone who has ever had an elevated blood sugar level is at risk for foot complications. It may be as simple as knowing that once in your life, even during pregnancy, you have had an elevated blood sugar level. If so, you are at risk and must monitor your feet. Diet-controlled diabetics, whether diagnosed as an adult or as a child, have feet at risk of diabetic complications. The simple rule: If you have ever been told that you are at risk of developing diabetes, you need to consider your feet and work to prevent injury. It starts with daily foot checks: inspecting all sides, including the bottoms, which can be done best with someone's help or with a mirror. During a foot check, any changes in the foot's shape or color, sense of feeling/sensation, painful areas or skin integrity need to be evaluated. Any new bunions, calluses or corns need to be identified and shown to a medical doctor. The overall foot shape could change due to a bone fracture that would also need the attention of a physician. Stress fractures are very small breaks in the bone that will not usually change the shape of the foot, but may cause pain, bruising or swelling. The color of the foot is important as it helps show any changes in blood flow to the foot. Darkening or loss of hair may indicate that the blood or nerve supply has decreased. Less blood to the foot can mean slower healing of cuts and scrapes. Bruises indicate injuries. Especially important are the bruises or cuts found during a foot check that the person was not aware of at the time of injury. Any bruises within calluses are particularly important to show to a physician. To monitor sensation, a feather or facial tissue can be used to brush the foot and test its ability to feel light touch. It is also important to be sure the foot can se Continue reading >>

Diabetic Foot Care Article

Diabetic Foot Care Article

A A A Diabetes mellitus (DM) represents several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body's ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. Foot problems commonly develop in people with diabetes and can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot. Sores may develop. Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life-threatening. People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent diabetic complications. People with diabetes should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also l Continue reading >>

Recovery After Diabetes Foot Amputation

Recovery After Diabetes Foot Amputation

If you’re getting a foot amputation due to diabetes, you probably have a lot of questions, especially about what will happen after the operation. Some of the things you can count on in the days, weeks, and months after surgery: medicines to fight pain and infection, help and advice on caring for your leg, and rehab with your new, artificial foot. It’s natural to feel scared or worried, but you won’t be alone in your recovery. You’ll work with a care team including your surgeon, your diabetes doctor, experts in artificial limbs, physical therapists, and others. They’re going to help you heal from surgery and get back to the things you love as quickly as possible. After your surgery, you’ll go to a recovery room. There, someone will monitor your blood pressure, pulse, and breathing. When those vital signs return to normal, you’ll move to your hospital room, where you can expect: Medical care, such as changing wound dressings and medicine for pain Physical therapy, such as gentle stretching and special exercises Information about your prosthetic, or artificial foot If the hospital sends you home after a few days, you’re off to a good start. That means your care team thinks you’re healing well and can take the lead on caring for yourself. To continue your progress, follow all your doctor’s instructions on bathing, activity, physical therapy, and caring for your wound. If you feel pain, don’t reach for whatever’s in your medicine cabinet. Only take what your doctor recommends because some pain medicines, even basic aspirin, can raise your chances for bleeding. Call your surgeon if you have any new symptoms, such as redness, swelling, bleeding, pain that gets worse, or numbness or tingling in the rest of your leg. Any one of these signs may be normal, Continue reading >>

Toe Amputation: Background, Indications, Contraindications

Toe Amputation: Background, Indications, Contraindications

Toe amputation is a common procedure performed by a wide variety of health care providers. The vast majority of toe amputations are performed on patients with a diabetic foot . [ 1 ] Although regional variation is noted, most of these procedures are done by general, vascular, and orthopedic surgeons (particularly those subspecializing in foot and ankle surgery); in some countries, podiatrists are involved. There are three broad indications for amputation of any body part, as follows (see Indications) [ 2 ] : Before any amputation, the clinician should ensure that the patients medical circumstances have been optimized (ie, should "reverse the reversible"). With impending toe amputation, this step encompasses such measures as glycemic control and consideration of revascularization when severe macrovascular disease is contributing to ischemia. The method of toe amputation (disarticulation vs osteotomy) and the level of amputation (partial or whole phalanx vs whole digit vs ray) depend on numerous circumstances but are mainly determined by the extent of disease and the anatomy. With any amputation, the degree of postoperative functional loss is generally proportional to the amount of tissue taken. The great toe is considered the most important of the toes in functional terms. Nevertheless, great-toe amputation can be performed with little resulting functional deficit. [ 3 , 4 ] A dead toe is one in which the blood supply is so completely impeded that infarction and necrosis develop (see the images below). Infarction results in dry gangrene, with nonviable tissue becoming dry and black in color (because of the presence of iron sulfide, a product of the hemoglobin released by lysed erythrocytes). Gangrenous fifth toe. Dubious perfusion in fourth toe. In Western societies, a Continue reading >>

Diabetic Foot Care - Neuropathy

Diabetic Foot Care - Neuropathy

Diabetes is a worldwide epidemic. Although the cause of diabetes is still unknown, we are learning more and more every day about this disease and the health problems it can create when not managed properly. According to the American Diabetes Association, nearly 7% of Americans have diabetes — that's 20 million people. Many don't even know they have it. To understand diabetes is to understand a complex system of causes and effects — a lot like a row of dominoes standing on end. A person with diabetes cannot properly process food into energy. Their bodies just don't produce enough of the hormone insulin to convert sugar into energy. This results in high blood sugar levels that can compromise the body's intricate system of veins and arteries. The resulting poor circulation causes a host of serious conditions including the potential for blindness, kidney failure, heart disease and nerve damage, especially in the feet. Nerve damage desensitizes feet, leaving room for problems that go undetected so long that they cannot heal. In severe cases, the only option for some foot infections and other diabetic foot disorders is amputation. How Can You Prevent the Domino Effect? This website will answer some of the questions you may have about how diabetes may affect your feet and how you can help to protect yourself from serious foot problems. It also will help you better understand what to expect if you do develop foot disorders. Why Focus on the Foot? Normal, healthy feet will show wear and tear as we age. Our feet change over time, losing some of the padding that once cushioned our steps. For those with diabetes, there really is no such thing as normal wear and tear. If you or a loved one has been diagnosed with diabetes, you should be aware of potential problems and how to avo Continue reading >>

How To Spot Diabetic Foot Complications Early

How To Spot Diabetic Foot Complications Early

How to spot diabetic foot complications early People with diabetes have a higher risk of foot amputation than anyone else. Heres what to look for to avoid the risk of serious complications. Warning: Some images in this article might upset sensitive readers. Diabetics should examine their feet regularly. ~ Foot infections are among the most common health complications in people with diabetes. When a seemingly normal wound is left untreated, it can become severely infected. We look at the reasons why diabetics should take special care of their feet. Why diabetics are prone to foot conditions Diabetics have abnormally high levels of glucose in their blood for long periods of time. This can lead to artery and nerve damage, which can compromise sensation in the feet. When diabetics get a simple cut, scrape or foot ailment and they leave it untreated, it can lead to serious complications. The two major conditions that can ultimately cause foot problems in diabetes are: Neuropathy occurs because of nerve damage, causing diminished sensation in the feet. This can lead to injuries such as wounds or scrapes getting infected. Peripheral vascular disease a condition that affects blood flow, making it more difficult for a cut or wound to heal. "It's not that these two conditions will cause ulcers as such, but they can result in extremely poor healing of any skin injuries. Often diabetics will have an injury, such as a blister or a cut, and because they have no feeling in that region, they do not realise that they have been hurt, and continue walking on an injured foot or leg," says podiatrist Chris Delpierre. As we now know, neuropathy and peripheral vascular disease associated with diabetes affect the feet. One of the biggest risks for diabetics is foot ulcers which can eventually Continue reading >>

Why Is Foot Care Important If You Have Diabetes?

Why Is Foot Care Important If You Have Diabetes?

Amputation is a major complication of diabetes. If you have diabetes, your doctor has likely recommended that you check your feet each day, but you may not have known why. Read on to learn how diabetes can lead to amputation and how to help prevent it. In some cases, diabetes can lead to peripheral artery disease (PAD). PAD causes your blood vessels to narrow and reduces blood flow to your legs and feet. It may also cause nerve damage, known as peripheral neuropathy. This could prevent you from feeling pain. If you can’t feel pain, you may not realize you have a wound or ulcer on your feet. You may continue putting pressure on the affected area, which can cause it to grow and become infected. Reduced blood flow can slow wound healing. It can also make your body less effective at fighting infection. As a result, your wound may not heal. Tissue damage or death (gangrene) may occur, and any existing infection may spread to your bone. If the infection cannot be stopped or the damage is irreparable, amputation may be necessary. The most common amputations in people with diabetes are the toes, feet, and lower legs. In 2010, 73,000 American adults who have diabetes and are over age 20 had amputations. That may sound like a lot, but amputations account for only a small percentage of the over 29 million people in the United States with diabetes. Better diabetes management and foot care has caused lower limb amputations to be reduced by half over the last 20 years. With ongoing diabetes management, foot care, and wound care, many people with diabetes can limit their risk of amputation or prevent it entirely. The best way to prevent amputation and other severe diabetes complications is to manage your blood sugar. There are several ways you can do this, including: eating a health Continue reading >>

Diabetes: Amputation For Foot Problems - Topic Overview

Diabetes: Amputation For Foot Problems - Topic Overview

Blood vessel and nerve damage linked with diabetes can lead to serious infections that are extremely hard to treat. Often the first place you have a problem is your feet. When you lose the ability to feel your toes and feet, you are more likely to injure them without knowing it. Even a minor injury, such as a small cut, can develop into an ulcer and a serious infection. Infections of the feet can spread up into the leg. Sometimes the infection is so severe that toes, the foot, and/or possibly part of the leg must be amputated. Amputations are done when efforts to save the foot or leg are unsuccessful or the infection is causing extensive tissue damage. In all cases, doctors save as much of a person's foot or leg as possible. But they try to make sure that the remaining part of the limb will heal so that further surgery is not needed. A serious infection can be life-threatening. In these cases, an amputation may save your life. If you are faced with needing an amputation, talk with your doctor about how it can benefit you. Often amputation relieves the severe pain linked with an infection, as well as getting rid of the infection and the need to take strong antibiotics. Also, modern prosthetic devices are lightweight, making walking as easy as possible after an amputation. Having a foot or leg amputated is traumatic and means a major body-image change. Allow yourself time to grieve and deal with what losing a part of your body means to you. If you need help, talk with your doctor about emotional counseling. You may also find it helpful to talk with a person who has had an amputation. This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.© 1995-2015 Healthwise, Incorporat Continue reading >>

Some Diabetes Patients Lose Lower Limbs Because Their Skin Changes

Some Diabetes Patients Lose Lower Limbs Because Their Skin Changes

Researchers from the University of Bristol, UK, have discovered why patients with diabetes develop a condition which leads to amputation of the lower limbs. It is caused by an alteration in their skin tissue before leg ulcers develop. It is not uncommon for a person with Diabetes Type 2 to develop an ulcer in the lower limb which does not heal. Eventually, the condition becomes such that the only effective treatment is to amputate below the knee. The best way to prevent an ulcer complication is to lower the patient's blood pressure, glucose and cholesterol. The problem is the condition is often undetected at its early stages. So, effective treatment can sometimes arrive too late. About 15% of people with diabetes who have a foot ulcer will need an amputation. People most at risk of ulcers that lead to limb loss are those with Type 2 diabetes (or adult onset of Type 2). In this study, scientists examined 14 patients with diabetes who had had an amputation below the knee. Skin tissue from their two legs were compared - the leg with the amputation below the knee and the healthy leg. They found that the leg with the amputation below the knee had problems with the connective tissue that supports the skin - the skin had changed. Tissue was being renewed at a much faster rate leading to abnormal collagen. The skin, being weaker, was breaking down faster - a condition which allows ulcers to form more easily. Now that we know why ulcers can happen, it may become easier to find ways of offering treatments which prevent the ulcer from developing in the first place. Understanding what happens in the tissue could allow doctors to develop treatments which prevent ulcers developing, and therefore help patients avoid amputations. Dr. J Tarlton, lead researcher said the results of the s Continue reading >>

Treatment Of The Diabetic Foot – To Amputate Or Not?

Treatment Of The Diabetic Foot – To Amputate Or Not?

Go to: Foot ulcers affect one in ten diabetics during their lifetime [1]. Patients with diabetes have increased risk of lower-extremity amputations and the main cause is diabetic peripheral arterial disease accelerated by the direct damage to the nerves and blood vessels by high blood glucose levels. Wound healing is also impaired from affected collagen synthesis [2, 3]. Diabetic vascular disease has three main components: arteritis and small vessel thrombosis; neuropathy (possibly ischaemic in cause); and large vessel atherosclerosis. In combination these are almost bound to cause problems in the weight- bearing areas. The diabetic foot ulcers are often deeper and more frequently infected than other leg ulcers reflecting the severe end vessel ischaemia and opportunistic infection which is the common experience of the diabetic [1–4]. Factors, such as age and the duration of the disease will increase its incidence and risk of death from uncontrolled infection [4, 5]. Once tissue damage has occurred in the form of ulceration or gangrene, the aim is preservation of viable tissue, but the two main threats are infection and ischaemia [3]. Ulcers should not be automatically treated with antibiotics since although as open chronic wounds there may be many commensal organisms, about half are not infected [3–5]. Several foot-ulcer classification methods have been proposed in order to organize the proposed appropriate treatment plan but none have been universally accepted. The Wagner- Meggitt classification is based mainly on wound depth and consists of 6 wound grades (Table 1) [6]. The University of Texas system grades the ulcers by depth, then stages them by the presence or absence of infection and ischaemia [6, 7]. As there is the need for rapid and more appropriate therapy Continue reading >>

Diabetes And Foot Amputation

Diabetes And Foot Amputation

How Diabetes Affects Feet People with diabetes are more susceptible to foot problems, often because of two complications of the disease: nerve damage (neuropathy) and poor circulation. Peripheral neuropathy causes a loss of feeling in the feet, reducing the ability to feel pain or injury. Poor circulation diminishes the body’s ability to heal, making it difficult to resist infection and heal injuries or wounds. For a person with diabetes, these complications can be a deadly combination. When a person with diabetes has neuropathy, they often cannot tell if their shoes are causing pressure and producing corns, calluses, cuts or blisters. These minor foot injuries can develop into ulcers, which is a break or hole in the skin. If poor circulation is also present, the ulcers can become infected and may not heal properly. This is a common complication associated with diabetes and can lead to a chronic foot ulcer, which is a leading cause of amputation. Amputation is considered when healing potential is poor or a serious infection becomes wide-spread, threatening the patient’s life. Preventing Complications It is vital for diabetics to take preventive measures to care for their feet, including wearing proper shoes, daily foot inspections and regular exams by a foot and ankle surgeon. Because even the smallest foot problem can turn into serious complications, it is important to seek treatment early for any issues, especially minor cuts, blisters and corns and calluses. When Complications Arise The loss of life and limb are real concerns for diabetics with a serious infection. Physicians and patients work together to consider the best options to treat the infection, prevent limb loss and to get the patient well as soon as possible. When Amputation is the Best Course of Treat Continue reading >>

How To Avoid Amputations If You Have Diabetes

How To Avoid Amputations If You Have Diabetes

In people with diabetes, a trifecta of trouble can set the stage for amputations: Numbness in the feet due to diabetic neuropathy (nerve damage) can make people less aware of injuries and foot ulcers. These ulcers may fail to heal, which can in turn lead to serious infections. "Normally a person with an injury on the bottom of their foot, such as a blister, will change the way they walk. Your gait will alter because you are going to protect that blistered spot until it heals up," says Joseph LeMaster, MD, an assistant professor at the University of Missouri–Columbia School of Medicine. "People with a loss of sensation don't do that. They will just walk right on top of that blister as though it wasn't there. It can burst, become infected, and turn into what we call a foot ulcer," he says. "That ulceration can go right down to the bone and become an avenue for infection into the whole foot. That's what leads to amputations." Foot injuries are the most common cause of hospitalizations About 15% of all diabetics will develop a foot ulcer at some point and up to 24% of people with a foot ulcer need an amputation. You're at extra-high risk if you're black, Hispanic, or Native American. These minority populations are two to three times more likely to have diabetes than non-Hispanic whites, and their rates of amputations are higher. "It's the most common reason that someone's going to be hospitalized with diabetesnot for high blood sugar or a heart attack or a stroke," says David G. Armstrong, DPM, a specialist in diabetic foot disease at Rosalind Franklin University of Medicine and Science in North Chicago. "It's for a hole in the foot, a wound." About a year ago, Dr. Armstrong treated a 59-year-old man with type 2 diabetes who had been working out at a local health club; 12 Continue reading >>

25 Must Know Statistics About Amputation Due To Diabetes

25 Must Know Statistics About Amputation Due To Diabetes

25 MUST Know Statistics About Amputation Due to Diabetes Diabetes is a common medical condition in the United States at least 9% of Americans are living with diabetes.[i] Diabetes affects many areas of the body. If youve been diagnosed with diabetes, you need to be aware of your feet and watch out for diabetic foot ulcers. What are diabetic foot ulcers? Diabetic foot ulcers are sores that develop on your feet, and they can develop even from seemingly trivial injuries to the feet. Diabetic foot ulcers are a common cause of amputation due to diabetes. If youre wondering about diabetic foot amputation statistics, be warned: these statistics may seem discouraging. But keep in mind that information can be empowering, and these stats emphasize the importance of seeking medical care for foot ulcers as soon as you notice them. The list also highlights the close connection between peripheral artery disease (PAD) , which involves the blockage of the blood vessels in the legs, and what the likelihood is that diabetic foot ulcers will heal. Hopefully this knowledge will remind you to take care of your feet if you have diabetes. If you have a diabetic foot ulcer that hasnt been treated, show it to your doctor as soon as possible. 25 Statistics Every Person Living with Diabetes Must Know About Amputation There are some surprising statistics about how common diabetic foot ulcers are, how often they can lead to amputation and the ultimate cost of having a foot ulcer that results in an amputation. 1. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes.[ii] 2. In the United States, every year about 73,000 amputations of the lower limb not related to trauma are performed on people with diabetes.[i] 3. Of non-traumatic amputat Continue reading >>

More in diabetes