How to Prevent Amputations

In people with diabetes, a trifecta of trouble can set the stage for amputations: Numbness in the feet due to diabetic neuropathy (nerve damage) can make people less aware of injuries and foot ulcers. These ulcers may fail to heal, which can in turn lead to serious infections.

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. But, 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 a foot ulcer. That ulceration can go right down to the bone and become an avenue for infection into the whole foot. And, that can lead to amputations.

Foot injuries are the most common cause of hospitalizations
About 15% of all diabetics will develop a foot ulcer at some point and up to 24% of people with a foot ulcer need an amputation. You're at extra-high risk if you're black, Hispanic, or Native American. These minority populations are two to three times more likely to have diabetes than non-Hispanic whites, and their rates of amputations are higher. 

Unfortunately, some people with diabetes don't believe that they will face amputation . This belief by some people with diabetes is primarily due to fear, denial and ignorance about the science of diabetes and how diabetes actually rots out the inside of the body.

Check your feet daily
Taking care of your feet is very important. The nerves of the feet are the longest in the body and are often affected by neuropathy.

The single most important thing that a person with diabetes can do to prevent a problem is to look at their feet every day, just as they comb their hair or brush their teeth.

Look at your feet every morning and every evening to check for cuts, sores, blisters, redness, calluses, or other problems. You can use a mirror to examine your feet or have a family member check your feet for you.

Here are some tips on preventing foot problems from the National Diabetes Education Program.

• Quit smoking if you're a smoker. Smoking is considered a likely factor in diabetic foot disease.
• Be super-vigilant about your controlling your blood sugar. According to results of the United Kingdom Prospective Diabetes Study, people with type 2 diabetes who lower their blood glucose through intensive therapy are at reduced risk for neuropathy.
• Choose shoes carefully.
• Cut your toenails carefully or have someone else do it if you already have numbness.
• Note: An increase in the temperature of your foot, which can be detected with a special infrared thermometer, can be an early sign of trouble. The foot will get hot before the skin breaks down.

Additional Ways to Care for Your Feet [Ref: Death to Diabetes Book, Chapter 15]

• Wash your feet in warm water every day. Do not soak your feet. Dry your feet well, especially between your toes. Rub lotion on your feet, but do not put lotion between your toes
• If your skin is dry, especially the heel of your foot, use a salt scrub to carefully remove the dead skin. (Thanks, Cynthia!).
• Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
• Always wear shoes or slippers to protect your feet from injuries.
• Always wear socks or stockings to avoid blisters. Wear thick, soft socks. Do not wear socks or knee-high stockings that are too tight below your knee.
• Wear shoes that fit well. Shop for shoes at the end of the day when your feet are bigger.
• If you have neuropathy, talk to your doctor about orthotics to improve circulation and relieve pressure.
• Check the temperature of bath water with your hand or arm before getting in the tub.
• Do not cross your legs when sitting.
• Make sure your doctor checks your feet at each checkup and performs the filament test by lightly rubbing a feathery filament across the bottom of your feet - to check for a loss of touch sensation.  If you do not feel the filament, it is imperative that you use your eyes to check your feet every morning and night.
• Note: If your feet do not sweat at all, this may indicate a loss of sweating and eventually a loss of touch sensation.  Unfortunately, this may eventually lead to foot ulcers. Notify your podiatrist and endocrinologist.
• Use one or more of the following therapies to help improve nerve health and the blood circulation in the feet: massage therapy, water therapy, acupuncture, magnetic insoles.
• Other natural treatment options for neuropathy may include: relaxation training, hypnosis, biofeedback training, acupuncture, transcutaneous electronic nerve stimulation (TENS) therapy.

In addition, follow a nutrient-dense nutritional program such as the Death to Diabetes Super Meal Diet that will help to control blood glucose levels and prevent the onset of diabetic neuropathy. Key foods, herbs and wholefood-based supplements include green vegetables, bright-colored vegetables, raw juices, beans, wild salmon, Omega-3 EFAs, evening primrose oil, CoQ10, cayenne pepper, garlic onions, ginger, and nattokinase.

Note: For more information about preventing diabetic amputations, refer to the Death to Diabetes website.