Diabetes and Amputation: Why It’s Done and How to Prevent It

Amputation can be a scary thing. 

I’m sure we all want to prevent amputation at all costs. 

If you have diabetes, you may be at higher risk of requiring a lower extremity amputation. 

Let’s talk about why this is and how to prevent it.

Diabetes and amputation

Amputation is one of the potential major complications of diabetes

If you have diabetes, you are likely aware of the importance of checking your feet on a regular basis.

Diabetes can increase your risk of developing peripheral artery disease. 

Peripheral arterial disease causes your blood vessels to narrow. 

This then reduces the flow of blood to your feet and legs.

Diabetes can also cause nerve damage. This is what we refer to as peripheral neuropathy. 

Diabetic peripheral neuropathy can prevent you from feeling pain. 

Although this may sound like a perk, it can actually prevent you from realizing you have a wound or diabetic ulcer on your foot. 

This can cause you to place pressure on the area of the wound. This can then cause the wound to grow and become infected.

In addition to this, the reduced blood flow in peripheral vascular disease can slow wound healing

It can also make your body less effective at fighting against foot infections. This means that the wound you have may not heal very well.

This can lead to tissue death, called gangrene. Infections could even spread to infect the bone. 

If the infection reaches the point where it can no longer be stopped or has caused irreparable damage, then diabetic amputation might be necessary.

The most common amputations in type 1 diabetes and type 2 diabetes involve the toes (minor amputation), the feet (transmetatarsal amputation and midfoot amputation), and the lower legs (leg amputation, transtibial amputation or knee amputation).

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Does everyone with diabetes deal with an amputation?

In the year 2010, 73,000 American adults over the age of 20 years with diabetes had amputations. 

Yes, that’s a lot of amputations! However, do keep in mind that over 29 million people in the United States have diabetes. 

Once you consider this, this is only an amputation rate of 0.25 percent of diabetic patients.

The good news is that awareness of the importance of foot health in diabetes has grown. 

This has led to better management of diabetes and improved foot care. 

This resulted in lower limb amputations for diabetes patients to decrease by half over the past 20 years. 

The risks of diabetic foot disease have gone down over the years.

Many people with diabetes can work towards diabetic foot amputation prevention or completely achieve limb salvage. 

They can do this with proper diabetes management, foot care, and foot wound care.

It is important to point out that amputation of one limb can increase your need for contralateral amputation (limb loss on the other side).

Warning signs of trouble

What may seem like a common foot problem can be a warning sign for someone with diabetes. 

This is because if you don’t know they’re there, these injuries can get infected or lead to diabetic foot ulcers. 

When this happens, we call these patients DFU patients. 

If you have diabetes, keep an eye out for the following warning signs of trouble:

  • Fungal infections (such as athlete’s foot)
  • Splinters
  • Ingrown toenails
  • Corns
  • Bunions
  • Calluses
  • Plantar warts
  • Chilblains
  • Hammertoes
  • Dry skin
  • Gout
  • Heel spurs
  • Heel pain

How to prevent amputation with diabetes

If you have diabetes and want to prevent whole and partial foot amputation, it’s important to take good care of your feet. 

Check your feet every single day. Look at your entire foot. 

You are looking for redness, bruises, blisters, wounds, and changes in color.

Use a magnifying glass to get a good look at your feet. If this is too difficult, have someone else check your feet for you.

Check your feet for sensation. 

Do this by using a feather or a similar soft object. Ensure your feet can sense hot and cold temperatures.

Wear clean, dry, thin socks that don’t have elastic bands. 

Keep your feet moving throughout the day. 

Wiggle your toes. Keep your ankles moving. This will help to encourage blood flow in your feet.

If you experience any numbness, burning, or tingling, then it’s important you report this to your doctor immediately.

What you can do now

Wash your feet every single day. Be sure to dry them well. 

Moisturize the skin of your feet to prevent them from cracking. 

If you do get any calluses, bunions, corns, or warts, then don’t remove them on your own. 

Instead, tell your doctor or podiatrist about them and get their assistance in dealing with this matter.

When you are cutting your toenails, go straight across. 

Be sure not to cut them too short. 

Don’t go barefoot outdoors or even indoors. 

If the problem is that you can’t find comfortable shoes that fit well, then talk to your doctor about prescription diabetic shoes.

Wear shoes that have closed toes. Do not wear shoes that have pointed toes.

Do not soak your feet in water. 

Moisture in between your toes can lead to an infection. 

To keep the skin between your toes dry, you can apply corn starch or baby powder.

Tips for managing diabetes

The best way to prevent diabetic foot complications such as proximal amputation is to manage your blood sugar levels. 

You can do this by implementing the following strategies:

  • Eat a healthy diet comprising of lean meats, fruits, vegetables, fiber, and whole grains
  • Avoid sugar-sweetened juice and soda pops
  • Manage your stress levels
  • Exercise for a minimum of 30 minutes per day
  • Maintain a healthy weight
  • Maintain a healthy blood pressure level
  • Check your blood sugar levels regularly
  • Take insulin and other diabetes medications as directed by your health care provider


Patients with diabetes are indeed at higher risk of peripheral artery disease, diabetic neuropathy, slow wound healing, and thus amputation and potential limb loss. 

But not everyone with diabetes necessarily has to deal with an amputation. 

Keep an eye out for any warning signs of trouble. 

You can prevent diabetes amputation by taking good care of your feet. 

You can also lower your chances of needing an amputation by managing your diabetes mellitus. 

Maintaining healthy blood sugar levels is the way to do this. 

Create a plan for this with your health care provider today.

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  1. Beaney, AJ et al.. (2016). Factors determining the risk of diabetes foot amputations – A retrospective analysis of a tertiary diabetes foot care service. Diabetes Research and Clinical Practice. 114 (1), 69. https://pubmed.ncbi.nlm.nih.gov/27103372/
  2. Gregg, EW et al.. (2014). Changes in diabetes-related complications in the United States, 1990-2010. New England Journal of Medicine. 370 (1), 1514. https://pubmed.ncbi.nlm.nih.gov/24738668/
  3. Taylor, J. (2017). Over-the-Counter Medicines and Diabetes Care. Canadian Journal of Diabetes. 41 (6), P551-7. https://pubmed.ncbi.nlm.nih.gov/29224633/

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