Does diabetes lead to amputation? How?

Answer 1

So the quick answer to this question is...it depends. As you know, an elevated blood sugar-especially over a prolonged period of time-will slowly begin to harden blood vessels. This begins with the smaller, more distal blood vessels-typically in the toes, feet, or lower extremities.

An elevated blood sugar can occur for several reasons, though is commonly associated with type 1 or type 2 diabetes. If either is well controlled with a nourishing diet, balanced exercise, and adherence to prescribed medications (eg. metformin, glipizide, jardiance, byetta, insulin, etc), then potential complications from diabetes can be kept at a minimum. That being said, if a patient has a poorly controlled blood sugar over time (eg. an elevated A1C), the patient will begin to manifest symptoms in their distal extremities due to the decrease in blood flow. They may experience peripheral neuropathy and subsequently have wounds on their feet that they don't feel. Wounds have difficulty healing in the presence of an elevated blood sugar and associated decreased blood flow. If a patient has a wound on their foot that they don't see, and don't feel, it can quickly become infected and progress to the point where more drastic measures are needed to prevent the spread of infection (such as hospitalization, tight blood sugar coverage, IV antibiotics, dressing changes, and potentially amputation).

Now obviously, not every diabetic patient will experience these complications. However, the risk of having peripheral neuropathy, diabetic foot ulcers, and amputation is inversely proportional to how they manage their blood sugar: Minimal blood sugar management=high risk of complications, including amputation. Excellent blood sugar management=low risk of complications, including amputation.