Diabetes: take steps to avoid amputation

How to avoid diabetes-related lower limb amputations

Around the States

One limb is amputated every two hours in Australia due to diabetes-related complications.


Every week, 85 Australians lose their toes, feet or even their legs - that's one limb amputated every two hours - because of diabetes complications.

Diabetic foot disease is the country's leading cause of amputations, and Australia has the second-highest rate of diabetes-related limb loss in the developed world, behind the US, with amputations up 30 per cent in the past decade. Aboriginal and Torres Strait Islanders are most at risk of amputation as a direct complication of diabetes.

And yet up to 85 per cent of diabetes-related amputations are preventable, according to Australia's peak body for amputees, Limbs 4 Life.

The charity has launched its Care 4 Feet campaign, urging all Australians to take care of their feet, reduce foot-related complications and visit a podiatrist regularly to prevent amputation.

"When you have diabetes or vascular problems you need to care for your feet every day," said Limbs 4 Life chief executive Melissa Noonan.

"If you are at risk have regular foot-health checks every three to six months and check your feet daily."

She said living with limb loss can have a significant impact on a person's mental and physical health and wellbeing, and it can also affect their ability to participate socially and economically.

"For each amputee around three other people are also affected, which means tens of thousands of supporters also join our limb loss community annually. When we consider the person and their immediate family, friends, work colleagues and social supports, the numbers of people directly impacted by amputation adds up significantly," she said.

Limbs 4 Life provides programs and services to tens of thousands of amputees and their care givers who rely on us for assistance prior to and post-amputation.

"It is important that we find ways to increase awareness of amputation nationally and also bring our amputee community together to reduce social isolation and promote connectedness," Melissa said.

How does diabetes affect feet?

Having diabetes may increase your risk of developing diabetes related-complications that include nerve damage called 'peripheral neuropathy' or poor circulation in your feet called 'peripheral vascular disease'. Nerve damage may affect how you feel pressure or pain and may lead to numbness in your toes or feet.

Changes to your circulation may delay your ability to heal any cuts or sores. This may also increase your risk of developing ulcers that may even lead to amputations.

What are the signs and symptoms?

Feet are often the first place to show such diabetic-related symptoms. This is why it is so important to pay attention to any such changes in your feet if you have diabetes.

Do you have cold feet, numbness, a sharp pain in your leg after walking, pins and needles, or any changes in foot colour, such as redder skin? Also look for any nail changes, corns, calluses, cracked or dry skin.

Seek urgent care if you have any signs of an infection, or your skin starts to breakdown - such as via an ulcer or a crack in your heels. Or if you have a new pain, swelling or redness in this area. This is even more important if you have already been diagnosed with nerve damage.

What are 'high risk feet'?

A high risk foot is one that is vulnerable to amputation. People with high risk feet usually have less sensation due to poor blood flow or nerve damage; meaning that feet may feel numb, cold or both. This is often the result of diabetes or vascular disease.

Due to the lack of sensation you may not notice things like a stone in your shoe, or if your shoe is not fitting correctly. Blisters or skin damage can go unnoticed. For this reason it is important to check your feet every day, and report any new problems immediately. People with high risk feet have usually experienced an ulcer, infection, or have possibly already experienced an amputation.

People with high risk feet should have regular check-ups. If you have high risk feet you should have them checked by your doctor or podiatrist every 3 to 6 months.

What can you do?

  • Make sure your feet are clean and dry, including drying between your toes.
  • Protect your feet. Wear correct fitting shoes and avoid going barefoot.
  • Moisturise your feet every day .
  • Check your feet every day for changes. Use a hand mirror to see underneath your feet
  • See your podiatrist regularly - and if you notice any changes to your feet, it is strongly recommended that you seek professional advice from a podiatrist.

How else can you look after your feet?

To prevent future foot problems, try and keep your blood glucose levels in your target range, avoid smoking, and keep physically active. Also, keep up-to-date with your annual cycle of care visits. By taking the right steps in looking after your diabetes, these complications can be delayed or prevented altogether.

To find out if you are at risk, take the Care 4 Feet quiz visit care4feet.org.au or phone 1300 782 231