Type 1 Diabetes and Amputation
One of the most mentally taxing aspects of living with type 1 diabetes is that the way we manage the disease directly implicates our quality of life when we are much older. Many complications won’t become a reality until 15 or more years of living with the disease.
Amputations are one of those realities and the possibility of having lower-extremity — toe, foot, or leg — amputations (LEA) increases by a large amount for someone living with T1D.
Understanding the Causes
Thankfully, it’s 100% possible to prevent amputations from occurring while living with type 1 diabetes. Amputations happen because of prolonged high blood sugar. Before the removal of a toe, foot or limb, a person living with type 1 diabetes will develop neuropathy. Research has found that women living with T1D have an 11% higher chance of having an LEA in their lifetime. For men living with T1D, that number rises to a whopping 21% higher chance.
Neuropathy is a general term for nerve damage and can cause loss of feeling in feet. When someone is suffering with foot neuropathy due to high blood sugar, it is possible they could be walking around with an ulcer or sore on their foot without them even knowing it. Therefore, it’s incredibly important to take care of your feet if you’re living with type 1 diabetes and regularity visit your endocrinologist for foot check-ups.
Types of Neuropathy
diabetic neuropathy is extremely common and affects between 60% and 70% of all people living with diabetes. There are two types of neuropathy: peripheral and autonomic.
Peripheral neuropathy affects limbs and causes tingling, numbness, and pain in hands, arms, feet, and legs. Peripheral neuropathy is more common, and when diagnosed it can be halted in its progression with proper (typically non-invasive) treatment. When ignored, peripheral neuropathy can lead to amputation.
Autonomic neuropathy affects the digestive system, bowel function, eyesight, bladder function, and sexual response, just to name a few. All diabetic neuropathy is caused by high blood sugar.
Tips for Preventing Diabetic Neuropathy
The absolute best thing you can do to prevent neuropathy from occurring is to keep blood sugar from being high on a regular basis. When blood sugar is above the suggested target for an extended period, it will slow down the circulation in the blood and start damaging nerves.
As mentioned above, this nerve damage won’t only occur in feet; it will most likely affect other parts of the body as well such as eyes, hands, and the digestive system. Staying hydrated, not smoking, keeping active, and reducing stress will help in preventing diabetic neuropathy. Having a routine for healthy eating and insulin intake that works for your lifestyle is imperative to leading a happy, healthy, amputation-free lifestyle with T1D.
Take Care of Your Feet
The most common way for the occurrence of type 1 diabetes and amputation to come about is if a foot gets infected and that infection goes untreated. It is very important to go see a doctor as soon as possible if you see an ulcer, callus, or any unusual changes in the texture or sensitivity of the skin.
Your doctor will guide you on how to take care of the problem in the best way possible to prevent the infection from progressing to an amputation.
On top of maintaining a good blood sugar range, actively making an effort to take care of your feet is a good idea for preventing ulcers and infections. Learn more about the importance of skin care with diabetes.
Healthy foot care should include:
- Avoid walking barefoot when possible
- Prioritize daily cleanliness
- Moisturizing your feet (but not in between toes; you want to avoid moisture build up and infection)
- Wearing proper footwear and socks (Have you heard of diabetic socks?)
- Checking your feet daily for cuts or infections
- Extra awareness of dryness during colder months
- Avoid soaking your feet in water for too long
- If possible, engage in nail maintenance
- Test your foot sensitivity with a feather or silk scarf
It’s can be easy to become overwhelmed when living with T1D by the fact that there is a higher possibility of having an amputation. You need to remember this when considering making some lifestyle choices.
It’s important not to see it as a definite part of your or your loved one’s journey with type 1 diabetes. It is something to be aware of and take into consideration when managing diabetes, but not something that should be thought about in-depth every day. As long as you are doing your best with the resources you have to manage your T1D, you greatly reduce the risk of needing an amputation.
Thankfully we live in a time where research and technology have made managing T1D easier and it is reducing the number of incidences of type 1 diabetes and amputation needed every year.
Testing for peripheral neuropathy should start no sooner than five years after the diagnosis of type 1 diabetes. Remember, if you are taking proper care of your diabetes and are not experiencing high blood sugar for a prolonged period of time, you don’t need to worry about amputations!