MUST LOSS OF LIMB BE A CONSEQUENCE OF DIABETES-MELLITUS

The loss of a limb in diabetes is usually preceded by intractable infection and spreading gangrene. These are late events in a long chain of destructive incidents to which the diabetic patient is particularly exposed. Chronic occlusive arterial disease (OAD) leads to tissue destruction or gangrene when injury or infection increases the demand for blood supply beyond the capacity of the collateral circulation. Good foot habits are protective. It would be absurd to maintain that loss of limb is no longer a hazard in diabetes. At present, none of the predisposing pathologic conditions can be averted, and accidental injury cannot always be prevented. The main hope today is a slowly growing awareness of a need for preventive care among all levels of the population, including the medical profession.