Brigette Honaker  |  July 18, 2019

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Diabetic Amputation Overview

A diabetic amputation occurs as a complication of a diabetic ulcer so severe that it warrants removing part of or all of the foot or leg. Diabetic ulcers, and subsequent amputations, are very preventable as long as patients take care of their feet and are not exposed to any additional amputation risks.

The source of most diabetic amputations is ulcers. If a diabetes patient has circulation problems, which is common in this population, their wound healing process may be slowed. This means that ulcers may not heal quickly and have more of a chance to become infected.

Additionally, diabetes can cause nerve damage in the feet, meaning that patients may not be able to tell when they are hurt. This can result in ulcers being missed until it is too late to treat them.

Warning Signs of Diabetic Foot Amputation

There may be some early warning signs of foot trauma that can lead to an amputation. In diabetes patients, this includes seemingly minor issues which can eventually turn into severe ulcers. Some signs of trouble may include: ingrown toenails, blisters, plantar warts, athlete’s foot, and the presence of ulcers.

A severe ulcer is usually indicative that a foot amputation may be necessary. Symptoms of a severe diabetic ulcer include:

  • Swelling;
  • Redness;
  • Warmth in one area;
  • Pain;
  • Discolored skin;
  • Foul odor from foot;
  • An ulcer that refuses to heal;
  • Ulcer symptoms last more than 1-2 weeks;
  • An ulcer is so deep that the bone underneath is visible.

Causes of Diabetic Amputation

Diabetic ulcers do not always lead to amputation. However, if an ulcer becomes severely infected or if treatment of an ulcer results in extreme tissue loss, amputation may be an appropriate treatment.

Treatment Before & After Diabetic Foot Amputation

Before an amputation is necessary, foot care is the best preventative treatment for an amputation. The Healthline suggests that patients do the following to ensure that their feet stay healthy and free of diabetic ulcers:

  • Inspect feet daily;
  • Wash feet daily;
  • Have a doctor remove calluses or foot lesions rather than doing it at home;
  • Trim toenails regularly;
  • Do not walk barefoot;
  • Wear clean, dry socks;
  • Buy supportive, comfortable shoes that fit properly;
  • Schedule regular foot checkups.

Other lifestyle changes may help prevent diabetic amputation, including: eating healthily; reducing stress; exercising daily; maintaining a healthy weight and blood pressure; regularly checking blood sugar; take all medications prescribed to treat diabetes; and quitting the use of tobacco products.

In some cases, foot care cannot help or the situation is out of a patient’s control and they are forced to undergo a diabetic amputation. After an amputation, patients are monitored in the hospital for several days to make sure their wound is healing correctly. Once a patient is able to leave the hospital, they may work with an endocrinologist, physical therapist, occupational therapist, mental health provider, and/or social worker to help adjust to their new disability.

Diabetic Amputation Complications

Unfortunately, having a diabetic amputation increases the chance of needing another amputation in the future. In order to stave of the potential risk of future limb loss, patients must stick to their diabetes treatment plan. This may include eating healthy foods, exercising regularly, controlling blood sugar, and avoiding tobacco.

Diabetic Foot Amputation and Invokana

The U.S. Food and Drug Administration (FDA) has confirmed that canagliflozin drugs are associated with a twofold increased risk of undergoing a lower limb amputation. Canagliflozin is a diabetes drug sold under brand names Invokana, Invokamet, and Invokamet XR.

Consumers who had to undergo a diabetic amputation of the toe, foot, knee, or leg may be able to file a lawsuit against drug manufacturers if they were not warned about the risk of amputation. An experienced diabetic amputation attorney can help evaluate your case and determine your eligibility for legal action.

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