Type 2 diabetic amputation can be the result of aging with diabetes. It is a specter that hangs over every older diabetic. The longer you have diabetes, the greater the chance for problems in your feet and legs.
Before home glucose monitors were invented, no one could track blood sugar levels several times a day.
A daily urine test told you the level of your blood sugar from the day before. It could not give you levels before and after meals, or warn you about low blood sugar.
So if a diabetic lived long enough there was a great chance to go through at least one below the knee amputation.
The sad fact is that today more than 60% of surgical lower limb amputations happen because of diabetes.
In the U.S., there are over 80,000 type 2 diabetic amputations a year from the complications of diabetes.
The number is high because there are more type 2 diabetics every year. In 1989, 6.7 million people in the U.S. said they had diabetes.
In 1995 the number grew to 8 million. In
2010 18.8 million Americans reported diabetes, but the CDC estimates another 8 million did not know they were diabetic.
Better and more accurate testing with the hemoglobin A1C and other tests explains some of the rise but not all.
It is scary to talk about type 2 diabetic amputation. But cutting off the leg below the knee was once the medical standard for necrosis (tissue death) in any part of the foot.
These days partial foot amputation is the first choice. However, one out of four partial foot amputations fail.
Then, about half of diabetics who need amputation are back for another one in less than five years. Why is this?
The path to type 2 diabetic amputation usually begins with a foot ulcer from a blister or sore that does not heal. This leads to infection, and flesh and bone begin to die. Without amputation the person will not survive.
Diabetic feet and hands are at risk, but below knee amputations are the most common. Your longest nerves and blood vessels are in your legs. Plus, your feet take a beating every day.
Nerve damage appears first in your toes and shins as numbness, tingling and nerve pain.
Numb feet are a huge danger as we age. An older diabetic could step on a nail and walk around with it in his foot and never know it. So you could have a blister or sore without pain for weeks.
Ulcerations on their feet quite often send diabetics into depression. This terrible enemy of diabetics will lead to giving up.
Surgeons say half of their patients who have type 2 diabetic amputation die within five years of the surgery.
The number of amputations is higher among diabetics who live alone. It is also higher if you have had type 2 diabetes for over ten years.
As diabetics get older, the risk grows. Long-term hemoglobin A1C levels of 9 or above put you at greater risk too.
Type 2 diabetics with a high resting pulse rate but low systolic (top number) blood pressure are more at risk.
Having diabetic neuropathies and/or peripheral artery disease (hardening, thickening of arteries in your legs), also increases risk.
A history of leg infections and foot ulcers is a big risk factor, and so is using shoes that don't protect your feet. Going barefoot is a great way to put yourself in danger of type 2 diabetic amputation.
Men have always had higher rates of amputation than women, and the rate grows rapidly among diabetics 75 or older.
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The CDC (Center for Disease Control) reports that from 1996 to 2008 there was a 65% decline in foot and leg amputations in the United States.
They think the cause is improved blood sugar control. Diabetics now get regular blood testing with the hemoglobin A1C and modern glucose monitors.
Diabetics are also taking better care of their feet, and there is less cardiac disease.
Doctors see faster healing and good surgical outcomes if their patients have a hemoglobin A1C at or below 7.
This is proof that good blood sugar control helps you heal. By the way, if you do not smoke you will heal faster too.
But here is the best news of all. Doctors see an 80% reduction in foot ulcers and amputations for diabetics who inspect their feet every day.
They do not ignore foot pain, and they make a habit of daily foot inspection.
Take care of your feet with diabetic shoes, look at them every day, and keep your blood glucose under good control. Those three things will protect you from foot problems like blisters and ulcers.
Remember that amputation is still eight times higher among diabetics than the general population. Stay alert for foot problems.
But there will always be risks as you age. If you do need partial foot or below the knee amputation, you will be far more likely to survive because you keep your blood sugar in good ranges. That is very good news.
They will keep you on the right track, but remember this.
We may beat type 2 diabetic amputation statistics, but none of us will beat death. The statistics on that are
100%. All we have is today. Let's make the most of it.
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