The idea of losing a limb is frightening, but for 15% of diabetic patients with foot ulcers, amputation is an unavoidable reality.
That’s the percentage of people with diabetes who must undergo amputation every year to avoid the deadly complications of chronic or untreated diabetic ulcers.
Even though rates of lower limb amputations have decreased more than 50% in the past 20 years, more than 70,000 people with diabetes still endure the pain, confusion, embarrassment, and trauma of foot or leg amputations every year.
As a diabetic, your high blood sugar levels automatically make you more vulnerable to wounds and infections. It’s essential to prevent avoidable injuries and seek immediate treatment for existing wounds in order to protect yourself from the threat of diabetic amputation.
What Is Diabetic Neuropathy?
Up to 70% of people with diabetes develop diabetic neuropathy, a condition of nerve damage that significantly increases the risk of amputation in the future. This occurs so frequently because high blood sugar levels damage the protective covering on the nerves and the blood vessels that deliver oxygen to nerves. Eventually, the damage becomes so extensive that nerves can’t efficiently send signals around the body.
Diabetic neuropathy is easiest to recognize by the numbness and tingling it causes in the hands and feet, but it also presents itself through other symptoms:
- Shooting or burning pains
- Vomiting, constipation, diarrhea
- Sexual dysfunction
- Urinary irregularities
- Dizziness, especially when standing up or walking
- Sensation of wearing an invisible sock or glove
- Difficulty sleeping because of feet and leg pain
- Loss of coordination and difficulty walking or moving the arms
This is known as peripheral neuropathy since it begins in the toes and fingers and moves up and inward along the body. You might experience constant or sporadic pain that develops suddenly or gradually over many years. Regardless, the signs of neuropathy indicate that you’re at risk of diabetic wounds that, if left untreated, often require amputation.
Why Does Neuropathy Cause Diabetic Wounds and Amputation?
Diabetic neuropathy restricts normal function of the nerves, which prevents the body, brain, and spinal cord from communicating properly. As a result, many of the 20 million Americans with diabetic neuropathy lose sensation in their feet, legs, and sometimes even hands and arms. Without the benefit of sensation, it’s nearly impossible to feel a skin wound when it develops. Some diabetics have such advanced neuropathy that they could step on a nail and not feel a thing!
Daily visual inspection of the feet and legs is the only way to identify wounds on your body if you have diabetic neuropathy. If you neglect to perform careful visual inspections, you could go days, weeks, or even months without ever discovering the deep and infected wound on your toe, foot, or leg. This leads to delayed wound care, uncontrolled infection, and possibly amputation to stop the spread of deadly gangrenous infection.
Other Causes of Diabetes Amputation
Diabetes itself significantly increases your risk of amputation since it’s a condition that automatically stunts your body’s natural healing mechanisms. This means that even a small, simple cut or burn could become a chronic non-healing wound that spreads infection deep down into underlying bone.
Unlike in a body unaffected by diabetes, which triggers a widespread natural healing process within minutes of any injury, a body with diabetes responds with a slow and restricted healing response. Blood struggles to flow, clot, and protect underlying tissues from bacteria. Nearby blood vessels can’t sufficiently deliver oxygen and nutrients to the wound, which further prohibits white blood cell activity and allows the wound to morph into an aggressive ulcer.
Diabetes is also correlated with poor circulation, which exacerbates an already compromised wound-healing process. Consistently strong circulation is essential to help red blood cells deliver nutrients to the wound. Without strong circulation, diabetic patients become even more vulnerable to infections and ulcers.
Important Facts to Know About Diabetic Amputation
The World Health Organization reports that amputations of the lower extremities are 10 times more common in people with diabetes than in non-diabetic individuals. Yet nearly 85% of amputations are preventable with early intervention.
Types of Amputations
You might picture an amputation as the loss of your entire leg, but amputations are used to different degrees in response to deadly wound infection. This type of procedure is only considered when your healing potential is so poor, and your infection is so strong, that your life becomes threatened.
If your wound is isolated, a partial toe amputation could be enough to remove your infection and protect the rest of your body from harm. Other situations involve partial foot amputations or below-the-knee amputations. Prosthetics can always be used to help you regain a full range of movement.
How to Avoid Diabetic Amputation
It’s true that many amputees learn how to live active and rewarding lives, but nobody wants to endure amputation in response to a diabetic wound. Fortunately, the majority of diabetic amputations are preventable with the following measures.
Diabetes Diagnosis and Treatment
Type 2 diabetes is a manageable disease. Even after diagnosis, healthy and strategic choices can help you reverse signs of diabetes altogether. Don’t run from your disease, as the medical consequences will catch up with you eventually. Instead, face your disease with proper diagnosis and treatment.
Undiagnosed and untreated diabetes poses numerous threats to your health and wellness, even before you consider the potential for ulcers and infected wounds. Poorly regulated or uncontrolled blood sugar levels cause your blood to thicken, force your heart to work harder, and put you at higher risk of these complications:
- Heart attack and stroke
- Vision problems that lead to blindness
- Teeth and gum infections
- Kidney damage
Work with your doctor to stabilize your blood sugar by reducing your intake of sugars and carbohydrates. When you turn your attention away from dangerous carbohydrates, you can start to enjoy whole foods that naturally normalize your blood sugar levels:
- Healthy fats like avocado, almonds, coconut oil, salmon
- High-fiber foods like fresh veggies, whole fruit, sweet potatoes, and beans
- Fresh herbs and spices
- Lean proteins like eggs, grass-fed beef, poultry, and Greek yogurt
It’s also helpful to adopt healthier lifestyle habits that support optimal blood sugar results. Exercise regularly, drink at least 8 cups of water a day, and find effective stress management techniques.
Aggressive Wound Care
Cut your chances of a diabetic amputation in half by educating yourself on proper diabetic wound identification and care procedures. This begins with daily inspections of your feet. Try making your foot care a regular part of your morning and evening routine, right after brushing your teeth and washing your face.
Carefully evaluate all surfaces of your toes, feet, and legs to identify any signs of new wounds or old, non-healing injuries. Even a minor cut can become a serious threat to your health if left untreated due to the negative impacts of diabetes on your body’s natural healing process. You can’t take for granted that any cut will heal quickly.
Once a diabetic wound is identified, it’s essential to use the proper types of wound dressing, infection control, and offloading to prevent ongoing damage.
The best wound dressing maintains a healthy amount of moisture on the foot to create a favorable environment for the wound. It must be changed at least once or twice per day, depending on the stage and severity of the ulcer. Wound dressing helps control infection, as do antibiotics.
Offloading is also a very important but often overlooked component of diabetic foot ulcer treatment. When you offload, you remove pressure from your injured foot and give new, healthy cells the opportunity to thrive. Crushes, knee scooters, and wheelchairs all accomplish offloading.
Improve Circulation With HBOT
Most of the core functions involved in wound healing are oxygen-dependent, so it makes sense that increasing oxygen in the body can support the wound-healing process.
Under normal circumstances, oxygen can only make its way through the blood within red blood cells. When red blood cells are too low or can’t circulate properly, important tissues become deprived of oxygen.
Cells that lack sufficient oxygen can’t produce the energy needed for bacterial defense, collagen synthesis, regeneration, or any other essential repair functions. Only concentrated oxygen flow through hyperbaric oxygen therapy (HBOT) can overcome such deficiencies.
HBOT performed in specialized hyperbaric chambers releases pressurized oxygen that permeates all areas of the body, even areas where circulation has become reduced or blocked.
This essential benefit of hyperbaric wound care stimulates and supports the body’s natural healing capabilities. When white blood cells receive enough oxygen, they can effectively kill bacteria, reduce swelling, and allow the rapid reproduction of new blood vessels. HBOT even enables cells to build new connective tissue and improve organ function.
Consider HBOT to treat your diabetic wound and prevent amputation, and you can expect to experience significant benefits to your overall health:
- Decrease fluid build-up in the tissues and help oxygenated blood flow through
- Increase the cells responsible for closing wounds and forming a barrier on the skin
- Boost antibacterial activity and response to antibiotics
- Stimulate the creation of new, healthy blood cells and collagen
- Support growth factor activity to regular wound healing
When you commit to weekly treatments in an ongoing protocol, HBOT revitalizes the body’s healing process and renews tissues you thought may never recover. Amputation doesn’t have to threaten your body or life!
The Bottom Line: Stop a Diabetes Amputation Before It Begins
When your health is on the line, you need and deserve the very best medical attention available. The experts at R3 Wound Care and Hyperbarics specialize in diabetic ulcer wound healing and aggressive wound care to ensure your non-healing injuries are treated quickly, efficiently, and safely.
Making the decision to trust R3 with your wound care is an important step toward safeguarding your limbs from the risk of amputation and improving your health for the future.
Dr. Hina Rizvi specializes in advanced wound management and hyperbaric medicine. She is a board-certified Wound Specialist by the American Board of Wound Management and a member of the American College of Hyperbaric Medicine.