How Diabetes and Smoking Can Lead to Amputation

Today, most people are aware of the harmful effects of smoking, particularly related to lung and heart health. But did you know smoking can impact the health of your feet?

The harmful chemicals in cigarettes, like carbon monoxide and nicotine, break down layers of cells in your blood vessels, which causes plaque and fat to build up in the vessel walls. This, in turn, can narrow and block arteries throughout the body, preventing adequate blood supply from reaching your feet. When this impacts the arteries in your extremities (arms and legs), it is called Peripheral Arterial Disease (PAD).

Restricted blood flow can also prevent the nerves in your feet from sending signals to the brain, which can cause peripheral neuropathy. Peripheral neuropathy can result in numbness, tingling, and a prickling feeling in the feet and legs. It can also prevent the communication of pain signals between the feet and the brain. For example, someone with peripheral neuropathy may not feel pain from a blister forming on the foot. If they aren’t performing daily foot self-examinations, it could continue to go unnoticed until it develops into an ulcer. This is a common occurrence, with as many as one in four diabetics developing a foot ulcer.

Ulcers are sores that appear as craters in the surface of the skin. The skin around the ulcer may be red and inflamed or rough and callused. If left untreated, a foot ulcer can quickly grow and impact the muscles, tendons, and bones of the foot. Infections, such as gangrene, can set in and cause additional complications. Those with diabetes and poor circulation are at a higher risk for ulcers. Between 14 and 24% of diabetics who experience an ulcer will require an amputation of the infected toe, a portion of the foot, or even the entire foot. Because peripheral neuropathy is characterized by a lack of feeling, symptoms can go unnoticed. Circulation issues, such as PAD, are also easily dismissed or misdiagnosed since the most common symptoms—leg cramping, numbness, and tired or sore muscles—can also be attributed to the pains of everyday life.

There is good news! Lifestyle changes such as smoking cessation, exercising, and healthy eating can all help reduce or reverse symptoms of poor circulation and peripheral neuropathy. If you are a diabetic, especially one who smokes, talk to your podiatrist today about your foot health.

It’s never too early to learn about your risk factors and work on a prevention or treatment plan for your pains. Call the FAAWC today to book your appointment.

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