Benjamin J. Makamson, D.O.
Lee C. Ferguson, D.O.
Michael B. Hogan, M.D.
Ralph B. Pfeiffer, Jr., M.D.

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Predicting Amputation Due to Diabetes and PAD.png

 

If you have type 2 diabetes, you’ve likely thought about limb amputation. Diabetic patients are at increased risk of amputation, accounting for up to 85% of daily limb amputations worldwide. This increased threat is due to a variety of factors, making it difficult - if not impossible - to reduce the risk completely. 

 

Luckily, researchers continue to study the connection between diabetes and amputation in an effort to more accurately predict and prevent the threat. One recent study suggests that doctors should be paying special attention to a subgroup of diabetic patients: those with Peripheral Artery Disease (PAD).

 

How Diabetes and PAD affect amputation risk

 

There is no doubt a connection between diabetes and Peripheral Artery Disease (PAD). Patients with diabetes are more likely to develop PAD, as high levels of blood sugar cause changes in the blood chemistry and artery walls that contribute to plaque buildup. Not only are diabetic patients more likely to develop PAD, but diabetes is also known to increase the progression and severity of the disease.

 

Diabetes and PAD each carry an independent risk of limb amputation, and that risk increases significantly when the conditions co-exist. In fact, the risks are directly related: diabetes causes slow-healing sores and PAD, which blocks the blood flow needed to heal the open wounds from reaching the extremities. As blood flow is restricted, tissue damage occurs and sores may develop gangrene, a dangerous and deadly infection. Diabetic patients may also develop nerve damage that decreases pain, causing dangerous foot ulcers to go untreated until amputation is the only answer.

 

Unfortunately, the burden of amputations is severe, causing a significant rise in five-year mortality rates. For this reason, experts have begun conducting studies to determine variable risk factors that increase the threat of amputation in diabetic patients. One such study recently published in Diabetic Medicine developed a new risk score model that could help physicians better treat patients that present with major adverse limb events (MALEs). 

 

Predicting Diabetic Limb Amputation with Risk Scores

 

There are many factors that put you at an increased risk for amputation, including:

 

  • Certain demographic factors (age, gender, ethnicity)

  • Smoking

  • Underlying conditions, especially diabetes or vascular diseases

  • A history of foot ulcers or prior amputations

  • Neuropathy status

 

In this new study, 14,752 patients with type 2 diabetes were assessed for major adverse limb amputations, including amputations, revascularization, and gangrene. By reviewing the data, experts were able to create a variable risk score model that ranges from 6 (low risk) to 96 (high risk).

 

The study found that peripheral artery disease was the leading risk factor for diabetic limb amputation. Negative outcomes were also more likely in patients over 50, males, and those with a history of smoking. Additional high-risk factors included coronary artery disease, unmanaged insulin use and a history of prior foot ulcers or amputations.

 

In the future, this new risk score model could be used to categorize patient risk of amputation based on the presence of certain individual factors, allowing doctors to provide more specialized care that reduces the threat of limb loss. 

 

Reducing Amputation Risk

 

By understanding the most prevalent risk factors, patients and physicians can take a more proactive role in preventing diabetic amputation. Doctors should take special care to closely monitor high-risk patients and manage underlying conditions like diabetes and peripheral artery disease. Patients should be taught to check themselves for dangerous foot ulcerations, make healthy lifestyle choices, and control their blood sugar levels.

 

If you have diabetes, being proactive about peripheral artery disease is one of the best ways to reduce the risk of amputation. Vascular Associates of South Alabama offers a wide range of PAD treatments and procedures to help you manage your condition and improve your overall health. Contact us today to schedule an appointment. 

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