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Why do diabetics need their legs amputated?

Why do diabetics need their legs amputated? Are there any alternative methods that can prevent amputation?

Diabetic people who require amputation(s) have such poor blood circulation in their extremities that their limbs are slowly dying and can become sources of generalized blood infections, which are deadly.

The high blood glucose of uncontrolled diabetes mellitus is very damaging to arteries throughout the body. Our bodies need a certain range of blood glucose to function well; one of the many things that happen when blood glucose is consistently too high is arterial damage.

When our arteries don’t work well, not only does that body part not get enough oxygenated nutrient-rich blood, it also can’t effectively move the deoxygenated, waste-rich blood out. The whole blood circuit is compromised and the tissues in that area become damaged.

Diabetic people can have very poor circulation to their extremities. They may get sores very easily, which don’t heal quickly or well because of the poor circulation. A limb may be amputated due to a long-term non-healing ulcer, before it becomes gangrenous or gets infected.

If the limb is not amputated soon enough, the infected ulcer may lead to sepsis (blood poisoning). Part of the treatment would still be to remove the source of the infection; that means the limb has to be amputated as soon as possible.

At this time, we have no methods repair the damage to arteries. The best way is to prevent the damage in the first place by maintaining blood glucose within the normal range (easier typed than done).

Anecdote: One of my diabetic nursing home patients had dry gangrene in her toes. Since it doesn’t hurt or smell and is not a source of infection, the doctor just left them alone. They were black. I don’t mean dark brown, I mean black.

One morning after we turned her and were about to put her top linens back on her, I saw one of her little black toes had fallen off in the bed. She didn’t know it, of course. She hadn’t felt that toe for years. That’s how dry gangrene works.

I kept it to show to the oncoming shift. The nurse did not appreciate it. No curiosity at all, some people.

It would have been much less weird if my patient’s daughter had not just painted all her mom’s toenails the day before. A lovely opalescent white.

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