Diabetes: Protect Your Feet and Legs

Foot and leg problems are a common diabetes complication, but taking the proper precautions can prevent up to half of all diabetes-related amputations.

By Lynn Yoffee

Medically reviewed by Pat F. Bass III, MD, MPH

If you have diabetes, you are more likely to develop leg and foot problems than those without this disorder. Diabetes can destroy nerves and cause you to have poor circulation. Left unchecked, these complications can lead to amputation. But there's a lot that you can do to prevent amputation.

Diabetes: Causes of Limb Problems

First, it's important to understand what causes these diabetes complications. Researchers are still uncovering the reasons, but they know that when you have high blood glucose levels, it can cause nerve damage called diabetic neuropathy. The damage can occur in any part of your body, but it is most common in your arms and legs, with the lower extremities affected first. This type of nerve damage is known as peripheral neuropathy. Some people have no symptoms, while others experience numbness, tingling, burning, sharp pain, cramps, extreme sensitivity when touched, and a loss of coordination and balance.

When you have peripheral neuropathy, small sores can go unnoticed because of the numbness — you simply don’t feel them. Left untreated, these little problems can become major infections that invade the bones. What’s more, poor circulation from diabetes means any ulcers and infections are harder to heal. If an infection invades your bones, then amputation could be required to save your life.

Here are some of the foot and leg problems related to diabetes that can lead to amputation if not treated promptly:

• Blocked blood vessels can occur in your leg below the knee when there is poor circulation from diabetes. Vascular surgery is usually needed to unblock them and restore circulation, but it is not always successful.
• Bunions and hammertoes may be caused by nerve damage. If they aren't treated, more ulcers (sores) can develop.
• Calluses and corns can result from ill-fitting shoes. Treat these early or they can become ulcers.
• Charcot foot is a foot deformity caused by neuropathy. An absence of pain could lead you to continue to walk on a broken bone, and then complications can develop.
• Cracked, dried skin might not seem like a big deal, but the cracks can turn into ulcers that won't heal.
• Nail problems such as ingrown toenails or fungal infections can also turn into ulcers.
• Osteoporosis can develop due to neuropathy and poor circulation. Brittle bones are more apt to break easily.

Diabetes: 13 Steps to Prevent Amputation

Fortunately, the National Institute of Diabetes and Digestive and Kidney Diseases reports that as many as half of all amputations related to these foot and leg complications can be prevented if the problems are caught early. Here are the most important things you can do to avoid amputation:

1. Quit smoking. The American Diabetes Association points out that if you're a smoker, quitting is the first and best way to prevent an amputation. Smoking decreases the blood flow in the small blood vessels of your legs and feet, making it difficult for wounds to heal.
2. Examine your feet every day. Check for anything out of the ordinary, from cuts and redness to a change in nail color. Even a loss of hair on your toes should be noted. You should also pay attention to the color of your feet and toes. If they turn purple, red, or pink, especially when you are sitting with your legs hanging free, you may have poor circulation.
3. If you discover any swelling, redness, pain, tingling, or numbness, call your doctor. Any pain in your legs after a little activity or at night can be a sign of a blocked artery — call your doctor immediately.
4. Be sure your doctor examines your feet at least once a year or whenever you notice a problem.
5. Carefully wash your feet in lukewarm water daily. Use a soft towel to dry them, including between the toes. Use lotion or cream to soften callused areas. If your feet perspire, use a non-medicated powder to keep them dry and prevent skin breakdown.
6. Don't use alcohol, hydrogen peroxide, astringent, or iodine on your feet.
7. See a professional for nail clipping, especially if you have any problems with your feet, such as numbness or hard nails.
8. Don't treat your feet with over-the-counter callus and corn remedies, and don't trim those growths yourself.
9. Keep the floor at home or work clutter free to avoid accidents.
10. Look at your socks for blood spots or other fluids. White socks are the best choice.
11. Select comfortable, sturdy shoes that fit right. Wear new shoes for just an hour or two at a time to break them in so that you won't develop sore spots.
12. Before putting on your shoes, check them for little stones or tears that could irritate your feet.
13. Generally, try to avoid anything that can hurt your feet. This can run the gamut from socks that are too tight or those with seams that can cause irritation to avoiding hot water, heating pads, and electric blankets which might burn a numb area of skin without your being aware of it. Going barefoot can leave feet vulnerable to cuts, puncture wounds, and splinters.

Take these preventive steps — and be vigilant about them — and you'll have an excellent chance of avoiding many of the diabetes complications that can lead to amputation.

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