Internally Peer Reviewed Four out of five limb amputations in the U.S. are performed on diabetic patients. But the first leads to the second. Prevention is the key. First, tight control of the diabetes by insulin or other treatment leads to less skin, nerve, and blood vessel damage and fewer foot ulcers.
Nerve damage means non-recognition by the patient that a disease process or injury is occurring.
In loosely controlled diabetes, there is poor scavenging of organisms by white cells, poor attraction of white cells to an area of infection, and poor killing of bacteria actually eaten by white cells. Immune levels in the blood are also low. From time to time, he had burning or shooting pains down his legs and, although parts of his skin were hypersensitive, he was unable to detect heat, cold, and vibration. His feet did not sweat normally and he had huge corns over his weight-bearing areas of the big toe, the heel, and the heads of the deep bones of the toes. He was cheerful, fun to talk to, and careless about his diabetes.