Reducing diabetic amputation rate

Every 30 seconds a leg is amputated somewhere in the world because of complications from diabetes, according to the International Diabetes Federation.

The chance of losing a leg is 25 times higher for patients with diabetes compared to those without the disease. In fact, up to 70 percent of leg amputations are carried out in people with diabetes.

Peripheral artery disease: a potential complication

Foot disease is one of the potential problems facing diabetes patients, in light of nerve damage and reduced blood flow to the legs.

Diabetes may affect nerve function and the ability to feel pain, so blisters and sores in the feet risk going unnoticed. This can lead to more serious infections that can spread through the whole foot or limb.

Moreover, the excessive amount of glucose accumulating in the bloodstream of diabetics can increase the risk of developing peripheral artery disease (PAD), where a build-up of fatty deposits in the arteries limit the flow of nutrient-rich blood to the lower extremities.

If left untreated, those conditions may result in gangrene – the death and decomposition of body tissue - and require an amputation to prevent the gangrene from reaching surrounding tissues.

Early intervention paramount in preventing amputations

Loss of mobility and independence is a tremendous price to pay for patients, who find it hard to keep their jobs and may plunge into depression.

At the same time, family members suffer from significant emotional distress, as their loved ones need round-the-clock assistance.

Prevention and early intervention is key to reducing the number of diabetics with PAD who end up undergoing an operation to amputate one of their limbs. The International Diabetes Federation reports that 85 percent of diabetic leg amputations can be prevented.

Monitoring risk factors is the first step. Patients need to maintain appropriate blood glucose, cholesterol and blood pressure levels by closely following the medication and dietary regimen prescribed by their clinician.

Secondly, it is crucial to improve arterial blood flow in the lower limbs through an angioplasty, stenting techniques or open bypass surgery. The first two procedures are minimally invasive but are not typically long lasting, so they may need to be repeated several times. By contrast, open bypass surgery has more durable effects, although recovery is longer and patients need to be in good physical condition for the intervention.

The third preventative measure is proper care of wound infections. This means checking one’s feet every day to detect any injury early and starting antibiotics when necessary.

This three-fold approach is the mainstay of prevention against amputation through which diabetes patients with PAD can maintain their mobility and quality of life. 

Material provided by Mount Elizabeth Hospital. Mount Elizabeth is a leading Singapore-based medical hub that attracts patients from all around the Asia-Pacific region. Both facilities in Orchard and Novena received the Joint Commission International (JCI) accreditation of quality care. 

Mount Elizabeth Hospital
3 Mount Elizabeth, Singapore 228510
Tel: +65 6250 0000

Mount Elizabeth Novena Hospital
38 Irrawaddy Road, Singapore 329563
Tel: +65 6898 6898
www.mountelizabeth.com.sg