Avoiding Amputations in Diabetics

TUESDAY, March 4, 2003 (HealthDayNews) -- Aggressive screening for evidence of nerve damage and sensory loss helps doctors identify people with diabetes who are at greatest risk for severe foot problems such as skin ulcers and a deformity called Charcot foot.

Left untreated, these serious foot problems can result in lower-limb amputation, says new research from diabetic foot care experts.

Sensory loss (neuropathy) is the most critical predictor of which diabetic patients will develop severe foot problems, according to experts, several of whom spoke at the recent annual meeting of the American College of Foot and Ankle Surgeons.

Simple neurological testing combined with a thorough patient history are the most useful tools in identifying diabetes patients with neuropathy and at the greatest risk for suffering crippling foot disorders.

Regular check-ups and daily patient inspections for sores, cuts and tiny puncture wounds can prevent or minimize diabetes-related foot and ankle problems. Early detection lets doctors begin treatment to prevent foot deformity and possible amputation.

Charcot foot occurs in about 30 percent of people with diabetes who have peripheral neuropathy. In its early stages, Charcot foot is often misdiagnosed as septic arthritis, gout, or osteomyelitis.

Pain, swelling, redness and heat are among the first symptoms of Charcot foot. Balance is affected and bones become soft and fracture-prone. Many people with Charcot foot aren't able to wear shoes.

In more advanced stages, Charcot foot causes loss of sensation in the foot and an inability to feel pain. Muscles are unable to provide proper support to the ankle joint, the foot becomes unstable and a reverse arch develops.

Walking makes the condition worse. Inflammation from the pressure of walking results in further instability, ulcers and dislocation. Eventually, the foot may collapse.

More information

Here's where you can learn more about foot care for people with diabetes.