Diabetes continues to be the single most common underlying factor related to lower-extremity amputation in the U.S. and Europe. The incidence of lower-extremity amputation increases with age. Amputations are significantly more common in men than in women and the incidence and proportion of lower extremity amputations is significantly higher in minorities. In addition, in Mexican and African American communities, 75–83% of all amputations occur in those with diabetes. In contrast, among non-Hispanic whites, approximately half of amputations occur in those with diabetes.
Diabetics should never walk barefoot, even in-doors. Something as minor as stubbing a toe on a coffee table or bumping a soccer ball at the park can lead to a serious foot ulcer. While at the beach, seashells, glass or debris from the ocean can puncture the skin and cause serious infections that can be perpetuated by diabetes. For diabetics with circulation problems or neuropathy when sensation in the feet is diminished, walking barefoot on hot pavement is especially dangerous and can lead to severe burns and infection. There are a variety of closed-toe beach shoes on the market that help protect feet against these types of injuries.
Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. . People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.