Diabetes management: Increase in amputation cases is a concern says, expert

Amputation due to diabetic foot ulcers and gangrene affect's a person's life psychologically, socially and economically

Debjani Arora | Published: August 20, 2018 10:07 am

One of the many complications of diabetes is amputation of limbs or a part of it like toes or the feet due to diabetic foot ulcers or gangrene. In diabetics, numbness in the feet due to diabetic neuropathy (nerve damage) makes them unaware of injuries and foot ulcers. These ulcers sometimes fail to heal, which in turn leads to serious infections. Uncontrolled diabetes can cause further damage to the nerves and reduce sensation. When this happens the injuries (even small ones) can keep worsening without any pain and becomes difficult to keep track off. Soon they develop into ulcers, infections and cause tissue death (gangrene). This leads to amputation in most of the cases.

Here Dr Pradeep Gadge, a leading diabetologist, Gadge Diabetes Centre talks about the rising cases of amputation in diabetics and why it is a matter of concern. “Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. Diabetes is the cause of nearly 80% of the traumatic amputation, with atherosclerosis or chronic arterial occlusive disease as the underlying pathology. Most of the amputations are lower-extremity amputations, such as foot amputation.”

What leads to amputation in diabetics

Dr Gadge says diabetic neuropathy develops in 60 to 70 per cent of people with diabetes. Risk of neuropathy and amputation increases with age, weight and the duration for which one suffers from diabetes, it is more among those who especially lived with the condition for more than 25 years. Poor diabetes control, abnormal cholesterol levels, and high blood pressure also increase risk. The risk is significantly greater among smokers.

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. 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 foot ulcer. 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.

The aftermath of amputation

Loss of a limb is a tragic event and in certain situations, amputation seems to be unavoidable. Today a number of people have experienced limb loss for one reason or the other, as a result of this; their lives have gone through a total change. Meanwhile, amputation itself is a change in body structure but has a great influence on many activities, participation in activities and quality of life. The patient may experience depression, anxiety, social discomfort and body-image anxiety. As a result of amputation, lifestyles changes become; source of living is partially or badly affected. In other words, amputation goes a long way to affect people psychologically, socially and economically. There are many factors that have been investigated in moderating a person’s psychological adjustment to losing a limb including patient demographics such as age, gender and level of education.

Looking beyond amputation

Even after amputation, it’s important to follow your diabetes treatment plan. People who’ve had one amputation have a higher risk of having another. Eating healthy foods, exercising regularly, controlling your blood sugar level and avoiding tobacco can help you prevent additional diabetes complications.

Image source: Shutterstock

Published: August 20, 2018 10:07 am

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