Amputations due to diabetes can be prevented

Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease a foot amputation.

"Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions," said Troy J. Boffeli, DPM, FACFAS, a Minneapolis-based foot and ankle surgeon speaking for the American College of Foot and Ankle Surgeons. "Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet."

Loss of sensation inhibits the body's normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.

Boffeli said foot and ankle surgeons use a variety of surgical and non- surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes. "Daily self exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected," said Boffeli. "If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing."

An estimated 7 in 10 diabetic patients have nerve damage that impairs feeling in their feet. Fifteen percent of diabetic patients eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have a foot or leg amputated will lose the other within five years. Proper diabetic foot care, says Boffeli, prevents foot loss.

In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can't improve blood circulation, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.

Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:

• Keep your blood sugar under control to help minimize cardiovascular and blood circulation problems
• Lose weight, don't smoke and adhere to prescribed dietary, medication and exercise regimens
• At least once a day, examine your feet for cuts and other small wounds you may not feel
• Never walk barefoot, outdoors and indoors
• Cut nails carefully - straight across and not too short; never trim corns and calluses yourself
• Wash your feet every day in lukewarm water; dry carefully
• Choose comfortable shoes with adequate room for the toes
• Wear clean, dry, non-bulky socks; change daily
• Shake pebbles or bits of gravel out of your shoes before wearing
• Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don't seem to be healing

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