Managing Diabetes to Prevent Limb Loss: Indications and Solutions.

Diabetes-related amputations are a significant issue in India, where over 77 million people are affected by the disease, making the country the diabetes capital of the world. According to the World Health Organization, individuals with diabetes are ten times more likely to undergo lower-extremity amputations compared to those without diabetes. If you have diabetes, you must know the risks and take proactive steps to manage your health.

What is Diabetes?

Diabetes is a chronic condition that directly impacts how your body converts food into energy. Typically, your body breaks down most of the food you consume into sugar (glucose) and releases it into your bloodstream. Elevated blood sugar levels signal your pancreas to release insulin, critical to allowing blood sugar into your body’s cells for energy use.

In diabetes, your body either doesn’t produce enough insulin or can’t use it effectively. This leads to an excess of blood glucose in your bloodstream, which, over time, can result in complications such as nerve damage (diabetic neuropathy) and circulation problems (peripheral artery disease).

Recognizing Symptoms - If you notice any of the following symptoms, consult your doctor:

• Increased thirst and urination

• Fatigue

• Blurred vision

• Unexpected weight loss

• Increased hunger

• Slow-healing sores and frequent infections

• Red, swollen gums

• Tingling or numbness in hands or feet

Early detection & treatment of these symptoms can help prevent complications and promote better health.

Diabetic Neuropathy

Diabetic neuropathy causes nerve damage, leading to symptoms like loss of sensation, numbness, heightened sensitivity, or tingling in your legs and feet. High blood sugar levels are believed to cause this nerve damage, making it difficult to detect injuries in your lower extremities.

Peripheral Artery Disease

Peripheral artery disease, or PAD, is common among diabetic patients in India. It is caused by the buildup of cholesterol and fats on artery walls, which restricts blood flow. This increases the risk of ulcers, infections, and potential amputations.

Steps to Improve Health

Maintain Blood Sugar Levels: Regularly monitor your blood glucose levels and occasional HbA1c tests to prevent neuropathy and peripheral artery disease.

Healthy Diet: Consume nutritious foods in moderate amounts at the right times. A balanced diet includes fruits, vegetables, and whole grains, which help maintain stable blood glucose levels.

Physical Activity: Exercise improves circulation and strengthens nerve tissues. Engage in low to moderate-impact aerobics and weight-bearing exercises, ensuring you check your blood sugar levels and stay hydrated. Always consult your physician before starting new exercises.

Medications: Follow your physician’s instructions regarding prescribed medications.

Foot Care: Inspect your feet daily for abnormalities like sores, cuts, bumps, and blisters. Wear well-fitting shoes and socks. Custom inserts, special shoes, and ankle-foot orthoses (AFOs) can help prevent pressure points, blisters, foot ulcers, and sores. Seek medical attention immediately if you find any problems.

Diabetes and Amputations

Unmanaged diabetes can lead to amputation of limb parts, typically of the toes or digits, feet, or legs. Consider the story of Mr. Majhi, aged 52, who has elevated blood sugar levels. Mr. Majhi has lost sensation in his feet, followed by chronic diabetic foot ulcers. Continued pressure on the wound causes it to enlarge and become infected, which progresses to dry gangrene and osteomyelitis. Despite efforts to manage the infection, it spreads, leading to the need for a lower limb amputation.

Prosthetic Care

Vispala Mobility Clinic offers comprehensive support for individuals who experience limb loss. Our prosthetists will work with you to understand your level of limb loss and lifestyle, often recommending custom-designed prosthetics that are lightweight, durable, and easy to use for diabetic patients. We will also guide you through post-surgery expectations, rehabilitation, and the use of prosthetic technology.

Vispala Mobility Clinic is dedicated to providing the care and resources you need to manage diabetic foot treatment, like pressure off loaders, custom diabetic foot insoles, and more.

References:

International Diabetes Federation (IDF), 2019. [Diabetes Atlas](https://www.idf.org/e-library/epidemiology-research/diabetes-atlas.html)

2. World Health Organization (WHO), 2016. [Global Report on Diabetes (https://www.who.int/publications/i/item/9789241565257)

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