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Why Do People Lose Their Limbs From Diabetes?

Diabetes And The Risk Of Amputation

Diabetes And The Risk Of Amputation

Diabetes is the most common cause of non-traumatic limb amputations. The most recent data from Public Health England shows that in one year, diabetes was the cause of around 6000 leg, toe or foot amputations in England. A staggering amount. People with diabetes are estimated to be up to 30 times more likely to have an amputation compared with the general population. The risk of foot problems in people with diabetes is increased and it is well known that anyone who has diabetes can be affected by foot problems. Diabetes can damage the nerves, muscles sweat glands and circulation in the feet, particularly when it is poorly controlled. Thus, it can affect the feet in a number of ways, and this includes loss of sensation and reduced blood flow to the feet which can have serious repercussions. For example, when skin on the foot is damaged it may not heal easily and it could cause an ulcer to form on the foot. It is estimated that 10% of people with diabetes will have a foot ulcer at some point in their lives. Similarly, if a person has lost feeling in their feet, then it is possible that they may damage their feet without realising it. It is understood that many diabetes-related amputations are preceded by foot ulceration caused by a combination of impaired circulation and nerve damage. Indeed, the estimate is that diabetic foot ulcers precede more than 80% of amputations in people with diabetes. Furthermore, after a first amputation, people with diabetes are twice as likely to have a subsequent amputation as those who do not suffer from the disease. The importance of good management of diabetes cannot be underestimated. Neither can the regular multidisciplinary review of diabetic patients. As part of the multidisciplinary approach to everyone who has diabetes should have th Continue reading >>

Why Do Diabetics Lose Their Feet And Legs?

Why Do Diabetics Lose Their Feet And Legs?

First, a disclosure: I am not an MD, just a medicine enthusiast. Tl;Dr : diabetics "lose" their feet because of tissue necrosis, infection and slow/non-recovering wounds, all of which are long term complications of diabetes. Other than that, diabetics stands at a higher risk of loss of feeling in peripheral limbs. Diabetes is an abnormally high level of glucose in the blood. the excess glucose damages all the functions of the circulatory system. The basic oxygen distribution is restricted and limited due to the formation of plaque in the arteries, essentially lowering the blood flow in them. In smaller arteries, the blood flow isn't slowed, it is stopped altogether, starving and eventually killing the cells down the line, making the tissue necrotic. Once a part of a limb turns necrotic, there is no other option but to remove it. Another function of the circulatory system that is severely weakened by diabetes is the delivery of immune system, more specifically, the ability of white blood cells to reach a wound in peripheral areas clogged up by plaque. This results in a more serious infection of the hurt limb. These infections are often aggravated because of the low oxygen supply to the infected area, since enough oxygen is paramount for quick wound recovery. Some diabetics show another symptom that puts them at an even higher risk of losing their feet. Advanced diabetes can cause numbness and even complete loss of sensation in toes and feet. Such inflicted person can accidentally hurt his feet, say step on a nail, and not be aware of that. Such person will discover and clean his wound later than he would wish, and experience unnecessary blood loss and increased chance of infection. His wound will also heal a hell of a lot slower than that of a healthy person. Losing a li Continue reading >>

The Cruel Cost Of Ignoring Diabetes: Jane Lost An Arm And Two Legs To The Disease Because, Like So Many, She Didn't Take It Seriously

The Cruel Cost Of Ignoring Diabetes: Jane Lost An Arm And Two Legs To The Disease Because, Like So Many, She Didn't Take It Seriously

Six years ago, Jane Knight was just another of Britain's army of multi-tasking women: a devoted wife and mother who frantically balanced looking after her family, including an autistic son, with her work as a complimentary therapist. But today, the 47 year-old is a triple amputee, having undergone operations to remove both her legs and one arm. She faces the prospect of losing her remaining arm in the near future. The cause of such devastating physical disability is not an horrific accident or advanced cancer but a condition that affects more than three million of us: diabetes. Furthermore, as Jane acknowledges, her situation could have been avoided had she done more to keep her blood sugar levels under control. Her story is a harrowing reality check to those who fail to understand how uncontrolled diabetes can cause wide-ranging health complications ranging from loss of sight, damaged kidneys, heart problems and even amputation. 'Diabetes is a condition that has to be respected otherwise the implications are horrendous,' she says. 'It was only when I became pregnant with my son, almost 20 years after first being diagnosed, that I realised how vital it is to keep the condition under strict control. Unfortunately by then the damage had started. 'I don't want anyone to feel sorry for me. I just want people to learn from my situation. When I hear of teenagers skipping diabetic clinics or adults who think that because they feel all right they can just ignore their condition, I want to scream in frustration. I want them to shout: "Look at me and see what diabetes can do. Is this what you want?"' Alarmingly, Jane's situation is not unique. It's thought that there are around a million people with undiagnosed diabetes ignoring warning signs such as wounds that fail to heal and Continue reading >>

World Diabetes Day: Too Many People Are Losing Lower Limbs Unnecessarily To Diabetes

World Diabetes Day: Too Many People Are Losing Lower Limbs Unnecessarily To Diabetes

It is estimated that more than 170 million people are suffering from diabetes globally and this number is expected to double by 2030. Diabetes and its numerous complications are extremely burdensome on the health and economies of countries worldwide. In high income countries, for instance, treatment of diabetic foot complications accounts for 15-25% of total healthcare resources for diabetes. This is an enormous waste not only of scarce public health resources but also of healthy lives. It is estimated that with basic diabetes management and care, up to 80% of all diabetic foot amputations can be prevented. Diabetes mellitus is a chronic disease caused by the body’s inability to produce insulin, or by the ineffective use of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems. Diabetic foot problems are caused by changes in blood vessels and nerves that can lead to ulceration and subsequent limb amputation. "It is unacceptable that so much disability and death are caused by leg amputations, when the solutions are clear and affordable," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health, "Small investments in prevention and education can mean fewer leg amputations, increased quality of life for individuals and dramatic reductions in health-care costs." Leg and foot amputations of people with diabetes can be prevented using low cost, low technology solutions. Simple behaviours should be encouraged such as regular foot examination and examining the inside of shoes before putting them on, not walking barefoot, wearing comfortable footwear, keeping feet clean, and maintaining good care of the skin and nails. “People Continue reading >>

Poor People With Diabetes More Likely To Lose Limb

Poor People With Diabetes More Likely To Lose Limb

MONDAY, Aug. 4, 2014 (HealthDay News) -- Poor people with diabetes are much more likely to lose a limb to the disease than affluent patients are, new research suggests. Researchers from the University of California, Los Angeles, found the odds of having a toe, foot or leg amputated was up to 10 times higher for diabetics who live in low-income neighborhoods. Most of these amputations are preventable if patients are diagnosed and get proper medical care sooner, the study authors noted. They added that their findings should prompt public officials to implement laws that help reduce barriers to health care . "When you have diabetes , where you live directly relates to whether you'll lose a limb to the disease. Millions of Californians have undergone preventable amputations due to poorly managed diabetes," lead author Dr. Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA, said in a university news release. "We hope our findings spur policymakers nationwide to improve access to treatment by expanding Medicaid and other programs targeting low-income residents, as we did in California in 2014," Stevens added. Uncontrolled diabetes can weaken the immune system and cause neuropathy -- nerve death or damage. As a result, a small cut could go undetected and quickly progress to a life-threatening infection. The early diagnosis of diabetes, proper management of the disease and expert wound care can help prevent complications that could lead to amputation . "I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life.' These patients are often the family breadwinners and parents of young children -- people with many productive years ahead of them," noted Steven 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 >>

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 >>

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 >>

Fewer Diabetes Patients Lose Limbs

Fewer Diabetes Patients Lose Limbs

Patients with diabetes are less likely to face foot or leg amputations than they once were, although they're still at higher risk of losing a limb than the general population, researchers found. Among diabetes patients ages 40 and up, hospital discharge rates for nontraumatic lower-extremity amputation fell an average of 8.6% per year between 1996 and 2008 (P<0.01), Nilka Rios Burrows, PhD, of the CDC, and colleagues reported in Diabetes Care. Yet amputation rates among diabetics in 2008 were still nearly eight times higher than those seen in nondiabetics, they said. "Continued efforts are needed to decrease the prevalence of [amputation] risk factors and to improve foot care among certain subgroups within the U.S. diabetic population that are at higher risk," they wrote. Over the past few decades, diabetes prevention and care have both improved significantly, the researchers said, which should be accompanied by reductions in rates of complications, such as foot and leg amputations. So to look at trends in rates of hospitalization for lower-extremity amputation, they assessed data from the 1988-2008 National Hospital Discharge Survey and the National Health Interview Survey. During that time period, the number of Americans diagnosed with diabetes rose "dramatically," the investigators found -- from 5.4 million in 1988 to 17.1 million in 2008. In contrast, the number of discharge amputee codes started at 52,868 in 1988 and ended at only 70,139 in 2008, peaking at 83,153 in 1996. Overall, the researchers found that the age-adjusted amputation discharge rate among diabetics ages 40 and up fell from 11.2 per 1,000 in 1996 to 3.9 in 2008 -- a drop of 8.6% annually, the researchers reported (P<0.01). Rates among nondiabetics changed little, although those among diabetics in 2 Continue reading >>

Ignore Warning Signs, Lose A Limb

Ignore Warning Signs, Lose A Limb

Yahoo!-ABC News Network | 2018 ABC News Internet Ventures. All rights reserved. For eight years, Jeanne Houtz, who has a family history of diabetes, ignored all the symptoms visual problems, weird sensations in her feet and blisters that would not heal. The San Diego woman was diagnosed with type 2 diabetes at age 40, but she refused to take her medications or to lose weight. Houtz never realized she was in danger until the bones in her right foot collapsed, causing wounds that eventually led to infection. But attention to this insidious disease came too late, and it finally cost her a leg, which was amputated in 2005. "I know I am the worst person on the planet, acting like this," said Houtz, now 56. "My mom had it, everyone had it," she said. "When I was a young girl, I had an aunt who had it and she was told not to eat brownies. She would crave them and I thought, 'Why does she eat them?' I later realized it's an uncontrollable urge." Houtz is one of 20.8 million Americans who have been diagnosed with diabetes, a disease that is now epidemic and is linked with the increased prevalence of obesity in the United States, according to the National Diabetes Education Program Progress Report 2007. About 6.2 million Americans have the disease, but go undiagnosed. The total number of people with diabetes in the United States is projected to rise from 17.7 million in 2000 to 30.3 million in 2030, placing the United States third in global prevalence, second only to India and China, according to the report. About 66 percent of all adult Americans are overweight, a major risk factor for type 2 or adult onset diabetes. Left untreated or not managed well, the disease can lead to peripheral neuropathy, which can lead to foot deformities and eventually amputation. Today, Houtz liste Continue reading >>

Why Do Diabetics Lose Their Legs?

Why Do Diabetics Lose Their Legs?

You have had problems with your foot for years. Your doctor now tells you that the foot needs to be amputated. How did this happen? Do you have to go through with the surgery? What will happen if you keep your foot? Diabetes is a devastating disease. It can be managed, and many of the complications of diabetes are preventable. This takes much dedication of the patient and a team of doctors. Discovering you have diabetes and making life changes to prevent life threatening complication of the disease is very difficult. Thus, many people still run into problems associated to diabetes. Foot problems are among one the most common complications. 70% of all limb amputations are due to diabetes! There are several reasons diabetics have foot problems but let’s talk about the three big causes. When the nerves are exposed to high levels of glucose or high blood sugars, they are slowly damaged. Thus, many diabetics suffer from peripheral neuropathy, a disease in which they slowly lose protective sensation in the feet. This can be very dangerous. I have had patients who had glass, needles, tacks and other objects stuck in their foot and they never remember how it happened. I have also had patients burn themselves in the bath tub. Their feet can no longer perceive temperature and they can easily burn or freeze their feet! Diabetics also suffer from poor circulation. Blood carries many nutrients and oxygen that is essential to keep tissues healthy. Poor blood supply makes it extremely difficult for damaged tissues to heal. When a patient has a wound or ulcer on the foot, their poor blood supply makes it is so hard for the area to heal. Diabetics also have a compromised immune system. The body is weakened in its defense mechanism to fight off infections. Infections kill good tissues Continue reading >>

Diabetes And Amputation: Everything You Need To Know To Avoid Amputation

Diabetes And Amputation: Everything You Need To Know To Avoid Amputation

In this article, we will cover everything that you need to know about how to avoid an extremity amputation due to diabetes. We will cover skin and foot care, what to look for, and when to contact your doctor. We will discuss whether or not you need to see a podiatrist, and what to do if you do have a diabetic foot ulcer. We will look at how to get it treated, so that it heals and doesn’t progress to amputation. We will also look at what to do if you are going to have, or have already had an amputation due to your diabetes. We will look at ways you can become mobile again safely. We will also discuss ways to protect your remaining limbs so that you don’t have another amputation later. We will discuss what to look for related to residual limb care, and how to locate needed resources, such as a physical therapist. In my own experience as a nurse for 22 years, and as a certified diabetes educator, I have seen many people with diabetes lose functional mobility, and even their life, after an amputation. I have seen a person go from having a blister and not even knowing they have diabetes to having a below the knee amputation in under two weeks. In addition, I have worked with people who have been through femoral popliteal bypass surgery, amputation of the toes, then a below the knee amputation. I have watched them come in and out of the hospital until they have an above the knee amputation. With cardiovascular disease, the risk of another amputation is very high. I have watched their pain and suffering, and seen the struggles that their families go through after amputation due to complications of diabetes. I have sat up late with them, while they try to deal with phantom residual limb pain, as their mind plays tricks on them and they feel pain in the already amputated leg Continue reading >>

Diabetes And Amputation

Diabetes And Amputation

Tweet Diabetes, when present in the body over many years, can give rise to all sorts of complications. These include heart disease, kidney disease, retinopathy and neuropathy. If left untreated, some of these complications can become extremely damaging to the body. Diabetes is a leading cause of amputation The NHS reports that people who have diabetes are 15 times more likely to undergo amputations than other people without the condition. Diabetes is one of the leading causes of amputation of the lower limbs throughout the world. Charity Diabetes UK notes that problems of the foot are the most frequent reasons for hospitalisation amongst patients who have diabetes. Many hospital visits due to diabetes-related foot problems are preventable through simple foot care routines. All people who have diabetes should have foot check-ups as a part of their regular care routine. What factors lead to amputation? Several key factors usually predispose ulceration and ultimately amputation. These include: Circulation problems Other damage to the foot How are these factors assessed? Diabetic foot complications are more common amongst the elderly, and amputation rates do increase with age. For people over 75 years old, the risk does increase considerably. All people who have diabetes should have a basic education in foot care, and beyond this they should have regular foot examinations. The risk for the development of ulceration can be assessed by basic clinical examination of the foot. What are major and minor amputations? Amputations in general, not just diabetes-related amputations, are classed as major and minor. Minor amputation regards removal of toes or feet. Major amputation refers to the above or below the knee amputation. How should I identify a foot at risk from amputation? Lo Continue reading >>

Diabetes And Foot Problems

Diabetes And Foot Problems

Foot problems are common in people with diabetes. You might be afraid you’ll lose a toe, foot, or leg to diabetes, or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can also help keep your feet healthy. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected. Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene. Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene. Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.” What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should inclu 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 >>

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