"My care was, in one word, excellent."
Amputation is a serious risk for people with diabetes. In fact, the chance of facing this traumatic complication is 28 times higher in people who have the condition—marked by high or poorly controlled blood sugar—than it is in people who don’t.
“Many patients we see have a diabetic foot ulcer,” says Glenn M. Aufseeser, DPM, a podiatrist at Monmouth Medical Center Southern Campus (MMCSC). “This type of nonhealing wound is the leading cause of hospitalization and amputation in people with diabetes.”
Wounds such as diabetic foot ulcers occur because high blood sugar can impair immunity and cause circulation problems that often reduce blood flow to the legs and feet. Diminished immunity and circulation both can hinder healing, trigger infections and cause damage to underlying structures and bones. In some cases, damage can become so severe that it’s necessary to amputate a toe, foot or leg.
Stanley Lefland of Lakewood can attest to that. “My diabetes progressed to the point that two of my toes needed to be amputated,” says the volunteer EMT with Jackson Township EMS. He received surgery and treatment at MMCSC’s Wound Care Center, including hyperbaric oxygen therapy. This therapy administers pure oxygen under high pressure to help blood carry more oxygen to tissues and promote healing. “My care was, in one word, excellent,” Stanley says.
Reducing Risks
But you may be able to curb the risk of needing drastic or specialized treatment. “It’s much easier to treat a minor foot problem before it becomes serious,” says Dr. Aufseeser. Key measures to prevent or minimize complications of diabetes include controlling your blood sugar, exercising daily and taking your medications as directed.
It’s also critical to take good care of your feet, especially while at home during cold winter months when people often become less active. Steps like these can help foster healthier feet.
Inspect your feet: Check feet daily for sores, redness, blisters, calluses, ingrown toenails, numbness, open sores or any temperature changes or hair loss. If you can’t see the bottom of your feet easily, use a mirror to get a better view.
Wash your feet: Use a mild soap and warm (not hot) water. Dry your feet well, especially between your toes. Apply a nonalcoholic lotion to keep skin soft and prevent cracks that can allow bacteria to penetrate skin and potentially trigger an infection. Don’t put lotion between toes as it can cause blisters, and don’t soak your feet because it can dry your skin and leave it more prone to cracking.
Trim toenails with care: Cut toenails straight across with straight clippers, and file down sharp edges. If desired, dust feet with a foot powder such as talcum or cornstarch.
Wear socks: Choose soft, seamless, padded socks to avoid sores and blisters. Make sure they don’t pinch or rub. Socks should be loose enough around the top that they don’t cut off circulation. Choose white socks made of fabrics that pull sweat away from your skin such as cotton or special acrylic. Avoid nylon.
Pay attention to shoes: Change shoes at least once daily to sidestep pressure points. Check shoes regularly for pebbles or sharp objects, and make sure they have enough cushioning for the heel, arch and ball of your foot. Select shoes with enough room for your toes, and if your feet are two different sizes, buy the larger shoes. Don’t wear sandals or flip-flops, and don’t go barefoot even at home.
Leave calluses alone: Don’t attempt to remove calluses or foot lesions by yourself. Avoid using nail files, nail clippers or scissors, and don’t apply chemical wart removers. Instead, see a podiatrist for expert care.
Quit smoking: Smoking constricts your blood vessels and limits oxygen to your extremities. Poor circulation is a large contributing factor to amputation risk.
“Following these steps and seeking care when needed can improve your long-term mobility, improve your quality of life and potentially increase your life expectancy,” Dr. Aufseeser says.
When to Call the Wound Care CenterPreventing foot problems and catching them early can go a long way toward helping you avoid amputation, but it’s also important to know when to seek medical care. Contact your doctor if you develop any of these potential signs of trouble:
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Do You Have Nerve Damage?Not being able to feel pain sounds like a good thing. But lack of pain due to nerve damage from diabetes makes it hard to detect foot sores, wounds or injuries. About half of people with diabetes develop some form of nerve damage, which can occur in any part of the body but most often affects feet and other extremities. Be especially alert to nerve damage if you:
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To learn more about treatment at MMCSC’s Wound Care Center or to make an appointment, call 732-886-4100.