Unmanaged diabetes can lead to amputations, usually of the toes, feet, or legs. Causes include reduced blood flow or peripheral neuropathy. Managing your blood sugar may help prevent it.

Limb loss and amputation are a rare, but major complication of unmanaged diabetes.

In the United States, almost 39 million people were living with diabetes in 2021. Each year, about 130,000 people with diabetes have an amputation.

This means around 0.3% of people with diabetes — or 1 in 300 people — receive an amputation yearly.

Diabetes management and amputation rates have improved in the last 20 years, but some research suggests that young and middle-aged adults in the United States are experiencing an uptick in diabetes-related amputations.

If you have diabetes, carefully following your management plan is key to preventing long-term complications.

Keep reading to learn more about how diabetes can lead to amputation and how to help prevent it.

Limb loss and amputation in diabetes are most commonly associated with long-term high blood sugar, blood pressure, or cholesterol levels, according to Diabetes UK.

There are two complications most commonly associated with leg amputations in diabetes: peripheral neuropathy and peripheral artery disease (PAD).

Peripheral neuropathy

Long-term high blood sugar levels, oxidative stress, and inflammation may cause nerve damage in the legs, feet, and toes. This is known as peripheral neuropathy.

If you can’t feel pain, you may not realize you have a wound or ulcer on your feet. You may continue putting pressure on the affected area, which can cause it to grow and become infected.

Over time, wounds, ulcers, and infections can completely damage the nerves in your lower limbs, possibly leading to limb loss and amputation.

Peripheral artery disease (PAD)

In some cases, unmanaged diabetes can lead to peripheral artery disease (PAD). PAD occurs when fat builds up in the blood vessels, causing them to narrow and reduce blood flow to your legs and feet.

Reduced blood flow can slow wound healing and make your body less effective at fighting infection, so your wound may not heal. Tissue damage or death (gangrene) may occur, and any existing infection may spread to your bone.

This may also result in amputation.

If you’re living with diabetes, it’s important to regularly monitor your blood sugar (glucose) levels and follow your diabetes management plan.

It’s also important to regularly check your feet for any signs or symptoms of complications, such as neuropathy.

The Centers for Disease Control and Prevention (CDC) recommends connecting with a doctor if you experience any of the following symptoms:

  • pain, burning, tingling, or numbness in your lower limbs
  • change in the size or shape of lower limbs
  • fungal infection (athlete’s foot) between your toes
  • a wound, blister, or cut you cannot feel
  • an ulcer that you can see the bone beneath

Proper management is key to preventing further diabetes complications, such as amputation.

The best way to prevent amputation and other severe diabetes complications is to manage your blood sugar levels. There are several ways you can do this, including:

Good foot care may help you prevent wounds or ulcers from becoming problematic. Here are some foot care tips:

  • Do a daily foot check of your entire foot. Look for discoloration, wounds, bruising, and blisters.
  • Use a magnifying mirror to help you get a closer look at your feet.
  • If you’re unable to check your feet, have someone else check them for you.
  • Regularly check your feet for sensation using a feather or other light object.
  • Regularly check to see if your feet can feel warm and cold temperatures.
  • Wear thin, clean, dry socks that don’t have elastic bands.
  • Wiggle your toes throughout the day and move your ankles frequently to keep the blood flowing in your feet.

Report any foot problems and neuropathy symptoms, such as numbness, burning, and tingling, to a doctor right away.

What you can do now

Here are some things you can do now to help keep your feet healthy and prevent complications:

  • Wash and dry them thoroughly every day. To help prevent skin cracking, apply a light coating of petroleum jelly.
  • Don’t remove callouses, bunions, corns, or warts by yourself. Get assistance from a podiatrist or a doctor.
  • Trim your toenails straight across, and try not to cut them too short.
  • Don’t go barefoot indoors or outdoors.
  • If you have trouble finding shoes that fit properly, talk with a doctor about prescription diabetes shoes.
  • Wear closed-toe shoes and avoid shoes with pointy toes.
  • Don’t soak your feet.

Common foot problems may become major problems if you have diabetes. If you don’t know they’re there, simple injuries may quickly become infected or cause ulcers.

If you experience any of these foot conditions, speak with a healthcare professional for an evaluation:

Amputation in diabetes is associated with a higher risk of mortality compared to people with diabetes who don’t have an amputation. A 2021 study in 324 people with diabetes found that 81.2% were alive 1 year after receiving amputation and 49.7% 5 years after.

After getting an amputation for your leg, you will likely stay in the hospital for 3 to 7 days. However, this time may vary based on several factors, such as how you’re recovering.

Unmanaged diabetes may lead to several leg complications, including pain, numbness, ulcers, infections, blisters, and in rare cases, amputation.

People with diabetes who have neuropathy may not walk as much, so there’s no stimulus for the muscles and bones to grow.

Diabetes is also associated sarcopenia (muscle loss) and PAD, two conditions that may increase the risk of weight loss in the legs. Unmanaged diabetes, sarcopenia, and PAD may impact the function of your muscles, tissues, and cells through several pathways, such as oxidative stress and inflammation.

Diabetes is a chronic health condition characterized by high blood sugar levels.

If left unmanaged, diabetes may lead to complications that could affect the nerves and arteries in your legs. Over time, this may cause infections that can lead to amputation.

It’s important to follow your diabetes management plan. Connect with a doctor as soon as possible if you experience symptoms like numbness, tingling, and ulcers in your legs.

Early detection and treatment are key to preventing amputation in diabetes.