– Why does untreated diabetes cause parts of limbs to die?
In: Biology
An effect of long-term high blood glucose is a condition called diabetic neuropathy, or peripheral neuropathy. This goes hand in hand with a lot of the other answers, but neuropathy is, as far as I can tell, the leading cause of eventual amputation with diabetes.
Nerve endings get damaged and the patient loses sensation in their extremities. This often leads to wounds or ulcers that go unnoticed. When these wounds are on the lower extremity they can go unnoticed because the patient just plain doesnt feel it! Since the wound is unnoticed they can become infected, become necrotic, and eventually require amputation. A big part of the care for diabetic patients involves education on the importance of inspecting their feet – but this can become difficult if the patient is very obese, elderly, or afflicted with any co-morbidities limiting range of motion.
When shadowing a family medicine physician I spent time with the Dietician who handled the the detailed cases for the clinic’s diabetic patients. Every patient would have a foot exam done, which consisted of us looking for any wounds, testing for sensory impairment (google neuropathy monofilament), and continued patient education on inspecting their feet daily.
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