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If you or a loved one suffers from diabetes, you may be aware of one of the more troubling aspects of diabetes: limb loss. It's true that diabetes can have dramatic effects on the body's vascular system. Over time, diminished blood flow means that wounds to extremities, such as feet, legs and hands, heal more slowly. And in worst-case scenarios, this can mean the limb itself may be jeopardized.
As a podiatric (foot and ankle) surgeon who specializes in preserving the limbs of diabetic patients – a field called limb salvage – I work with a team of specialists and our patients to implement a strategic plan to preserve the limb and restore healthy blood flow.
But a key part of what I do is educating patients and their family members on the importance of prevention. Because if you can identify the signs of diabetic foot damage, you can work with your doctor to treat your limb as problems arise, and you're less likely to need limb salvage at a later date.
The Hidden Dangers of Diabetes
While many diabetic patients and their families know that limb loss from diabetes is possible, patients often don’t know how to spot symptoms they may be experiencing from diabetic limb damage.
The three top signs of diabetic limb damage are:
Neuropathy, or nerve damage, is one of the most important signs of diabetic foot damage. High or unstable blood sugar levels, over time, cause vascular changes that can choke off or damage nerves. Diabetic neuropathy first affects the body's smallest nerves, such as those in the hands, feet, eyes, and kidneys. Neuropathy initially feels like a pins-and-needles or tingling sensation, and with time it can become a burning feeling that can impede sleep. But in later stages, neuropathy can cause numbness, which is far more dangerous, because the diabetic can no longer feel pain in the limb. Since pain is an important sign of injury or infection, this can lead to serious complications.
Vasculopathy, or peripheral arterial disease, is another significant complication. Diabetes can cause blockages in veins and especially arteries in diabetic patients. This can cause color changes or thinning of the skin, or atrophy. One of the most common signs of vasculopathy is pain when at rest or elevating the legs.
Finally, diabetes can result in a compromised immune system, making fighting off infections – even routine ones – much more difficult. For example, what would otherwise be a small, trivial wound can fail to heal for a diabetic patient, creating a major infection. So it’s important to keep an eye on any changes in your ability to recover from injuries or infections.
You may not consider any of these on their own as something that requires immediate medical attention, but they can point to serious problems down the road, if they’re not examined further by a doctor. But true prevention in this area means maintaining awareness around these signs and proactively seeking the care of a podiatrist, if and/or when they arise.
Your podiatrist will be able to tell you if you’re experiencing something that’s part of a larger diabetic health issue and help you potentially mitigate the effects they have your life – that includes reducing the risk of future amputation.
A Well-Integrated Team
At MedStar Washington Hospital Center, the care we provide to our diabetic patients requires an integrated approach, involving professionals across several medical specialties. This increases our patients’ chances of preserving the affected limb. Infectious disease specialists, for example, prescribe antibiotics to help fight infections, and intensivists monitor the patient's medical status and optimize their nutrition for rapid healing.
So if you are seeking comprehensive care for diabetic limb damage, look for a multidisciplinary team that takes this kind of integrated approach. Because while a podiatrist should be your first call if you’re experiencing symptoms, such as neuropathy or vasculopathy, a more dimensional set of experiences and skill sets will be needed to ensure the best possible outcomes for you or your family, if the symptoms are indeed a sign of diabetic limb damage.