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Amputation and diabetes: How to protect your feet

How can amputation be prevented?

To prevent diabetes complications, make a commitment to managing your diabetes. Eat healthy foods, include physical activity in your daily routine and keep your blood sugar under control. Then put your best foot forward with these simple foot-care tips:

  • Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.
  • Inspect your feet daily. Check your feet for blisters, cuts, sores, redness or swelling once a day. If you have trouble bending over, use a hand mirror to see the bottoms of your feet or ask someone to help you.
  • Trim your toenails carefully. Trim your nails straight across. If you have any nail problems or poor feeling in your feet, ask your doctor about professional nail trimming.
  • Don't go barefoot. Protect your feet with comfortable socks and shoes, even indoors. Make sure new shoes fit well, too. Even a single blister can lead to an infection that won't heal.
  • Wear clean, dry socks. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid those with tight elastic bands that reduce circulation or that are thick or bulky. Bulky socks often fit poorly, and a poor fit can irritate your skin.
  • Use foot products cautiously. Don't use a file or scissors on calluses, corns or bunions. You can injure your feet that way. Also, don't put chemicals on your feet, such as wart removers. See your doctor or podiatrist for problem calluses, corns, bunions or warts.
  • Don't smoke or use other types of tobacco. Smoking reduces blood flow to your feet. Talk to your doctor about ways to quit smoking or to stop using other types of tobacco.
  • Schedule regular foot checkups. Your doctor can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Your doctor may refer you to a foot specialist (podiatrist).
  • Take foot injuries seriously. Contact your doctor if you have a sore or other foot problem that doesn't begin to heal within a few days. Your doctor may prescribe antibiotics to treat an infection. In other cases, infected tissue may be drained or removed. Sometimes surgery is needed to remove infected bone or increase blood flow to the affected area.

What if amputation is the only option?

If an infection has progressed too far or becomes life-threatening, an amputation may be the only option. The surgeon will remove the damaged tissue, being careful to preserve as much healthy tissue as possible. After surgery, you'll be monitored in the hospital for a number of days. It may take four to eight weeks for your wound to heal completely.

While you're recovering from surgery, your rehabilitation team — which usually includes a physical therapist, occupational therapist, social worker and other health professionals — will help you adjust to life after amputation. You may be fitted for an artificial limb and learn exercises to strengthen the affected area. You may learn how to use assistive devices and adapt your home, if needed, to help you resume your usual activities. If you experience pain in the amputated limb (phantom pain), you'll learn techniques to deal with the discomfort.

Even after amputation, remember that it's important to follow your diabetes treatment plan. Eating healthy foods, exercising regularly, controlling your blood sugar level and avoiding tobacco can help you prevent additional diabetes complications. If you're having trouble accepting the amputation or how it's changed your life, share your feelings with friends, loved ones or other close contacts. If necessary, contact a mental health professional for additional support.

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References
  1. McCulloch DK. Evaluation of the diabetic foot. http://www.uptodate.com/home/index.html. Accessed June 18, 2009.
  2. Foot complications. American Diabetes Association. http://www.diabetes.org/type-2-diabetes/foot-complications.jsp. Accessed June 18, 2009.
  3. Diabetes. American Podiatric Medical Association. http://www.apma.org/MainMenu/Foot-Health/FootHealthBrochures/GeneralFootHealthBrochures/Diabetes.aspx. Accessed June 18, 2009.
  4. Brownlee M, et al. Complications of diabetes mellitus. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Elsevier Saunders; 2008. http://www.mdconsult.com/das/book/body/145782590-3/0/1555/197.html?tocnode=54108749&fromURL=197.html#4-u1.0-B978-1-4160-2911-3..50034-0_3012. Accessed June 24, 2009.
  5. Amputation. Society for Vascular Surgery. http://www.vascularweb.org/patients/NorthPoint/Amputation.html. Accessed June 24, 2009.

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Oct. 2, 2009

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