We all know gifted jazz singer Ella Fitzgerald (1917 – 1996) for her beautiful voice in songs like “Mac the Knife,” “If You Can’t Sing It, You’ll Have To Swing It” and “A-Tisket, A-Tasket.” Over the course of her 59-year recording career, Ella sold 40 million albums, won 14 Grammy Awards and received honorary medals from Ronald Reagan and George H.W. Bush.
What you may not know about the “First Lady of Song” is that she had both her legs amputated below the knee due to complications from diabetes in 1993. She died just three short years later at age 79.
Ella Fitzgerald is a famous face among the 65,700 or so nontraumatic lower limb amputations that occur each year as a complication of diabetes. More often than not, these amputations were preventable, so let’s take a look at the top causes of amputations in diabetics.
1. Nerve Disease / Neuropathy
“Nerve disease caused by type 2 diabetes is the leading cause of amputation of feet, toes, legs, hands and arms among diabetes sufferers,” reports Insulite Laboratories, a research group dedicated to reversing insulin resistance in diabetic patients. It is estimated that 50% of people with diabetes have some form of neuropathy. The longer an individual lives with diabetes, the greater the likelihood he or she will have a numbness and weakness in the body — particularly the feet. People who have trouble controlling their blood sugar are particularly at risk. Loss of sensation in the feet means that pressure, injury, blisters and sores often go undetected. Without proper treatment, wounds can become infected and spread to the bone, which typically requires amputation.
2. Diabetic Foot Ulcers
A Swedish study published in 2012 found that 88% of diabetes-related amputations were preceded by ulcers. Deep blisters which break open into a wound or ulcer, exposing the tissue under the skin, are a leading cause of amputation, according to the Amputation Prevention Center of America. “The ulcer can become infected,” they explain. On top of that, the poor circulation diabetics so often have “impairs the ability of the body to heal the wound.” Ulcers can run deep within exposed tendon, muscle or bone. When the injury cannot heal, amputation may be required to prevent an infection from spreading.
3. Diabetic Foot Infections
Diabetes suppresses a person’s immune response, which predisposes individuals to bacteria and infection. Once bacteria gains access to the underlying tissue, the infection can spread rapidly down the long tendon to the foot. Limb-threatening infections must be treated in the hospital with IV antibiotics and often surgery. Lesser infections may be treated with oral antibiotics in an outpatient setting. Infections of the bone, called osteomyelitis, are common. To diagnose a bone infection, doctors must take an MRI scan of the bone and perform a culture of the bone to determine the type of bacteria causing the infection. This process could take three days to complete. Nearly 1 in 5 diabetic foot infections require some sort of amputation, says the Amputation Prevention Center. Foot surgery is viewed as a “last resort” procedure, but it can be the only way to get rid of a deep infection in a diabetic wound.
Diabetic Foot Care: Preventing Amputation
Insulite Labs offers a variety of tips for preventing unnecessary amputations. They recommend:
- Cleaning the feet daily with warm water
- Inspecting the feet and toes for cuts, blisters, swelling and redness daily
- Moisturizing the tops and bottoms of feet with lotion
- Filing corns and calluses with a pumice stone
- Cutting toenails and filing the edges with an emery board
- Always wearing shoes and socks for protection
- Choosing shoes that fit and allow the toes to move, and
- Seeing a podiatrist regularly.
We recommend adding daily sanitization of footwear with the SteriShoe ® UV shoe sanitizer. In addition to being vigilant about your feet, you can also limit contact with harmful fungus, bacteria and pathogens that breed in the dark, moist shoe environment. Diabetic foot care may seem like a hassle at first, but keep in mind: a little bit of extra precaution today can prevent life-altering heartache tomorrow.