The diagnosis of type-2 diabetes or what is otherwise known as the adult-onset version of the disease can bring scary warnings to the patient of potential heart disease, ketoacidosis, circulatory problems, neuropathy, and damage to the extremities leading to possible leg amputation and potentially a diabetes medication lawsuit.

Diabetic neuropathy—the condition which often leads to toe and leg amputation–occurs in roughly half of people with type-2 diabetes. Diabetic neuropathy affects the toes, feet, legs, hands and arms.

What Is Diabetic Neuropathy?

Diabetic neuropathy is a condition in which nerves have sustained damage because of sustained higher-than-normal blood sugar. There are several types of diabetic neuropathy, according to the American Diabetic Association (ADA), including peripheral, autonomic, cranial, femoral, focal, thoracic-lumbar radiculopathy, unilateral foot drop, and Charcot’s joint.

Peripheral neuropathy is most common, as indicated by Very Well Health, and the risk of developing it increases the longer you have adult-onset diabetes and the older you get. Issues maintaining an appropriate weight will also ramp up the likelihood of the problem raising its ugly head.

According to the ADA, the experience of peripheral neuropathy is often first noticed as reduced sensation. This state is often combined with tingling, a feeling of “pins and needles” in the affected area—much like the extremity has “fallen asleep”—increased sensitivity to pain, pressure or cold.

What About Diabetic Neuropathy Leads to Toe and Leg Amputation?

The problem with reduced sensation—much like that of Hansen’s Disease—is that small injuries can happen and go unnoticed until more serious damage has occurred. These injuries can turn into ulcerations, infections, and eventual gangrene. When this level is reached, amputation becomes vital to save other healthy, functioning parts of the extremity in question, according to Very Well Health. Additionally, some diabetes medications have been linked with an increased risk of experiencing a digit or limb amputation.

How Does Current Diabetic Treatment Affect The Likelihood I Will Experience An Amputation?

A common treatment for type-2 diabetes has been associated through a study with higher than average risk for amputation. The treatment is with a class of drugs known as sodium glucose cotransporter 2 (SGLT2) inhibitors. The study was published in the British Medical Journal on Nov. 14, 2018.

The increase in risk was twofold that of those patients in a control group taking a comparative drug in the GLP 1 receptor agonist class. Nevertheless, the author of the study, based in Sweden, encouraged reviewers to balance this increased risk against the drug’s benefits. This cost-benefit analysis should be done in consultation with an endocrinology specialist.

The medications that may be likely to result in an amputation are Jardiance and Farxiga. SGLT2 inhibitors work by preventing glucose from being reabsorbed into the bloodstream. Instead, this glucose is filtered out through the urine.

As diabetics are already at an increased risk of experiencing serious complications including gangrene or amputation, deciding whether to take a drug that could amplify these risks may be a difficult choice. If you have experienced side effects including complications that lead to the need for a foot or leg amputation after taking Jardiance or Farxiga, you may be able to speak with an experienced attorney about your case and determine what your legal rights are.

Who Is at Risk for Amputation?

In addition to the increased risk of amputation associated with SGLT2 inhibitors including Jardiance and Farxiga, there is some evidence that pre-existing conditions such as gout may also increase the risk. Gout is a form of arthritis that occurs when uric acid crystalizes and builds up in the joints. These sharp crystals may cause swelling, tenderness, or pain in the joints, most commonly the big toes.

According to a study published in 2020, patients who have been diagnosed with both type-2 diabetes and gout may be 25 times more likely to require an amputation than people who have neither condition.

Another common cause of amputation is the development of diabetic foot ulcers. Experts say that diabetic foot ulcers are the most common reason why diabetic patient will be hospitalized. Unfortunately, around 15% of people with diabetes will develop an ulcer at some point. Once the ulcer has developed, the prognosis is not positive. Around 24% of people who get a foot ulcer will then need an amputation according to Health.com. The most common amputations suffered by people with diabetes are amputations of the toes, feet, or lower legs.

The risk of diabetic amputations is higher for some demographic groups than others. Reportedly, Black, Hispanic or Native American patients are two to three times more likely to develop diabetes than white patients, and once they develop the condition, these patients are also at an elevated risk for diabetic amputations.

U.S. News & World Report explains this increased risk for diabetes may be linked to a lack of access for minorities who may face socioeconomic disadvantages. Experts stress that preventative care and education are key to ensuring patients have the resources they need to avoid developing type-2 diabetes in the first place, and to treat it properly if they do develop the condition.

Reportedly, early testing of blood sugar levels is one way in which communities can help patients be aware of their blood sugar levels, so they can take steps to ensure that their blood sugar stays in a healthy range.

According to U.S. News & World Report, the use of preventative care does vary among demographic groups. For example, in 2010, 75.2% of Black diabetic patients on Medicare received a certain cholesterol test, while 81.5% of non-Black patients received the same test. 

How Do I Reduce the Risk Of Amputation In Myself?

Very Well Health says that there are numerous actions that a diabetic patient can take to reduce risk of a diabetic amputation. Chief among those actions are regular foot checkups through your general practitioner or by a licensed podiatrist. Regular toenail trimming by a professional, daily foot washing and drying, and wearing clean socks with supportive shoes are critical.

Keeping blood sugar levels within the desirable range is of utmost importance as well. Following a strict diabetic diet, getting adequate and regular exercise, along with checkups is vital. Finally, the use of tobacco should be avoided.