Amputation and diabetes: How to protect your feet
Good diabetes management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation.By Mayo Clinic Staff
Diabetes complications can include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly.
The good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years.
When foot ulcers do develop, it's important to get prompt care. More than 80 percent of amputations begin with foot ulcers. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg.
Some people with diabetes are more at risk than others. Factors that lead to an increased risk of an amputation include:
- High blood sugar levels
- Nerve damage in the feet (peripheral neuropathy)
- Calluses or corns
- Foot deformities
- Poor blood circulation to the extremities (peripheral artery disease)
- A history of foot ulcers
- A past amputation
- Vision impairment
- Kidney disease
- High blood pressure, above 140/80 millimeters of mercury (mmHg)
Here's what you need to know to keep your feet healthy, the signs you need to see a doctor and what happens if amputation is necessary.
Preventing foot ulcers
The best strategy for preventing complications of diabetes — including foot ulcers — is proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring and adherence to a prescribed medication regimen.
Proper foot care will help prevent problems with your feet and ensure prompt medical care when problems occur. Tips for proper foot care include the following:
Aug. 08, 2017
- Inspect your feet daily. Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. If you have trouble reaching your feet, use a hand mirror to see the bottoms of your feet. Place the mirror on the floor if it's too difficult to hold, or ask someone to help you.
Wash your feet daily. Wash your feet in lukewarm (not hot) water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin where calluses easily form.
Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft. Preventing cracks in dry skin helps keep bacteria from getting in.
- Don't remove calluses or other foot lesions yourself. To avoid injury to your skin, don't use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. Don't use chemical wart removers. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.
- Trim your toenails carefully. Trim your nails straight across. Carefully file sharp ends with an emery board. Ask for assistance from a caregiver if you are unable to trim your nails yourself.
- Don't go barefoot. To prevent injury to your feet, don't go barefoot, even around the house.
- Wear clean, dry socks. Wear socks made of fibers that pull sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation or socks with seams that could irritate your skin.
Buy shoes that fit properly. Buy comfortable shoes that provide support and cushioning for the heel, arch and ball of the foot. Avoid tightfitting shoes and high heels or narrow shoes that crowd your toes.
If one foot is bigger than the other, buy shoes in the larger size. Your doctor may recommend specially designed shoes (orthopedic shoes) that fit the exact shape of your feet, cushion your feet and evenly distribute weight on your feet.
- Don't smoke. Smoking impairs circulation and reduces the amount of oxygen in your blood. These circulatory problems can result in more-severe wounds and poor healing. Talk to your doctor if you need help to quit smoking.
- Schedule regular foot checkups. Your doctor or podiatrist can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Schedule foot exams at least once a year or more often if recommended by your doctor.
See more In-depth
- Kaushansky K, et al., eds. Complications of diabetes mellitus. In: Williams Hematology. 9th ed. New York, N.Y.: McGraw-Hill Education; 2016. http://accessmedicine.mhmedical.com. Accessed June 20, 2017.
- Gregg EW, et al. Changes in diabetes-related complications in the United States, 1990-2010. New England Journal of Medicine. 2014;370:1514.
- Standards of medical care in diabetes — 2017. Diabetes Care. 2017;40:s1.
- Beaney AJ, et al. Factors determining the risk of diabetes foot amputations —
A retrospective analysis of a tertiary diabetes foot care service. Diabetes Research and Clinical Practice. 2016;114:69.
- Diabetes and foot problems. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems. Accessed June 21, 2017.
- Today's podiatrist talks about diabetes. The American Podiatric Medical Association. http://www.apma.org/diabetes. Access June 21, 2017.
- The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. Chicago, Il.; Society for Vascular Surgery. https://vascular.org/research-quality/clinical-practice-documents/clinical-practice-guidelines. June 21, 2017.
- Weintraub AC, et al. Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities. https://www.uptodate.com/contents/search. Accessed June 20, 2017.
- Amputation. Society for Vascular Surgery. https://vascular.org/patient-resources/vascular-treatments/amputation. Accessed June 21, 2017.