Amputation due to diabetes can happen when prolonged high blood sugar levels lead to nerve damage or poor circulation. This can cause wounds that don’t heal.
The good news is that most diabetes-related amputations are preventable with early care, healthy habits and regular foot checks. Understanding the signs and taking action early can protect your mobility and long-term health.
Why amputation due to diabetes happens
Ron Holbrook, a physical therapist and amputation program manager at Encompass Health Rehabilitation Hospital of Concord, said many of his patients have had an amputation due to diabetes, especially type 2 diabetes. According to the CDC, diabetes accounts for 80% of all lower limb amputations (LLAs), which underscores the importance of early prevention.
"One of the most important ways to reduce your risk of type 2 diabetes and, therefore, amputations (or additional amputations) would be to develop healthy eating habits, a more active lifestyle and improved control of insulin management," Holbrook said.
Peripheral arterial disease (PAD) and poor circulation
Poor blood flow caused by plaque buildup is one of the leading causes of amputation.
"A complication of diabetes is poor blood flow, which leads to peripheral arterial disease (PAD)," Holbrook explained. PAD, also known as atherosclerosis, develops when arteries become narrowed or blocked, making it harder for blood to reach the legs and feet. Without enough circulation, the skin and tissues cannot heal properly.
Ulcers, or open wounds, may form on the lower extremities. These wounds can worsen quickly if circulation remains low.
"Poor blood flow results in poor healing of ulcers and infection, which can then lead to amputations," Holbrook said.
Symptoms of PAD to look for include weakness, cramping and pain while walking. If you notice these symptoms, reach out to your doctor.
Diabetic neuropathy and loss of sensation
High blood sugar over time can also lead to neuropathy, especially in the feet. This condition, known as diabetic neuropathy, affects your ability to feel pain, pressure or changes in temperature. This means that nerves do not send accurate signals to the brain when something is painful or wrong with the feet, and it becomes harder to notice injuries.
"Patients may start with a small ulcer or wound that they can't feel. Left untreated, the wound becomes severe enough that the body can no longer heal due to the poor blood flow. This is when amputations are likely to happen," Holbrook said.
How to reduce the risk of amputations due to diabetes
Properly caring for your feet is key to reducing your risk of amputation due to diabetes. You can do this by:
- Performing daily foot checks. Look for breaks in the skin, blisters and discolorations. Check between your toes and check inside your shoes before putting them on. If you see a new wound or sore, contact your physician or podiatrist right away.
- Wearing clean, dry socks. Socks protect feet from irritation and injury. White socks can help you notice blood if you do get a cut.
- Wearing and shaking out your shoes. Open-toed shoes don't protect feet as well as closed-toed shoes. With open-toed shoes, small debris can become lodged in the skin leading to damage. It's also important to shake out your shoes daily to remove any small objects like pebbles.
- Visiting your doctor or podiatrist regularly. Routine exams of your feet are important for early detection. A healthcare professional can identify issues you may not notice on your own.
Know the signs
If you notice any of these symptoms, contact your doctor:
- Ingrown toenails
- Blisters
- Athlete's foot
- An open sore or bleeding
- Swelling and redness
- Warmth on your feet
- Discolored skin
- A foul odor
- An ulcer that lasts more than one week
- A sore that is slow to heal
If you’ve already lost a limb due to diabetes
People who have had an amputation are at a higher risk for another one. "You can reduce your risk of further amputations with daily skin checks, continuing with routine healthcare and maintaining a good support system," Holbrook said.
If your doctor has recommended a post-acute care setting for amputation recovery, consider inpatient rehabilitation to continue recovery and improve your quality of life. You'll participate in therapy three hours per day, five days a week to achieve your personal goals. Inpatient rehabilitation can help you learn to properly care for your wound, adjust to life after limb loss, improve your mobility with a prosthesis and offer emotional support.