Sparing the details, a colleague of mine recently had his big toe amputated due to diabetes. I wondered why being diabetic could lead to this as it’s common.
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Type 1 here.
Many comments touch on it, but it is also a very complicated issue. Type 1 and Type 2 diabetes are very different diseases, but the side effects can be similar.
Even in well-controlled diabetes (either type), complications can occur. One of these is something called neuropathy. This is where a person has decreased nerve responses, which can lead to things like numbness and impotence.
If such an individual gets a blister or wound on their foot, if left untreated, it could get really bad, but this is true for anyone. But the person with neuropathy doesn’t have the same pain feedback so is less likely to notice, which could lead to a much worse infection by the time it is found.
Add to that that feet are slow to heal as they have decreased blood flow as they are the most distal (far from the body). Constant use also makes tissue repair slower.
Pain is there to help people from using injured parts. Without that feedback, it’s easier to hurt yourself.
Adding to this is that those with uncontrolled diabetes (either type) are more likely to have things called comorbidities, which are other issues which may not be related to the disease, but could make it harder to treat. Many type 2s tend to be overweight, but that may be due to an insulin resistance problem. Regardless, being overweight puts you at risk for high blood pressure as the body needs to compensate for moving all that extra blood by the heart pumping harder.
These are just a couple of examples. Trying to ELI5, but it is very complex.
Moral of the story is to try and take care of yourself and do regular body checks, including your feet, and try not to go outside without proper shoes on.
I certainly feel for type 2s. Imagine living your whole life a certain way and then being told to completely change your lifestyle. It’s hard to change, more so as you get older. Type 1 sucks a lot, but at least I got it young enough (reminder that even adults can get type 1 though) to not be completely set in my ways. My 90+ grandmother just got diagnosed with type 2 and she’s certainly taken an “eff it” approach. I can’t say i blame her at that age. I don’t want her to suffer, but I also understand that we both know it’s the end game and she’s got to enjoy what time she has left. Chances are she won’t live long enough to suffer the long term complications. But me? I’ve got many decades until I reach the “eff it” stage and as a type 1, those complications can come much faster.
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