It becomes an infection hazard. So… they just don’t have any other choice yet without a systemic reboot of the insulin system and cell-by-cell repair. They’ve made a lot of progress though, which is why it’s essential they don’t overcharge for insulin in the meantime.

It's someting you have, not what/who you are.

https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/amputation-and-diabetes/art-20048262

Circulation issues causing slow healing, nerve damage (peripheral neuropathy) with loss of feeling.

Wounds ulcerate and can become gangrenous. That's when amputation is in order to preserve life.

Managing blood glucose levels as close to normal is the best way to stave off a whole host of diabetic complications.

I'm in my 33rd year since diagnosis. I may have the very early stages of diabetic kidney disease.

Be constantly vigilant!

smallest toes. I was referred to a podiatrist and after the second visit she wanted to operate to remove bone structure in my foot that was keeping the crack open. Unfortunately, I was on indigent care at the time and it was during COVID so most of the indigent care personnel was working remotely. Despite two telephone calls from the podiatrist to the indigent care office to get the surgery approved, someone screwed up and the podiatrist didn't receive approval. About three months after my initial visit with the podiatrist I became extremely weak and eventually the skin on top of my foot turned black and the skin was flaking off like tissue paper. I developed an infection (sepsis) and they started by removing two toes. About a week later a third toe was removed and the surgeon said that another operation was necessary to amputate my leg since the infection had spread throughout my entire foot.

So the summary is that I had 103 degree fever, sepsis, and three operations during a 15 day period. Additionally, my brother is incapable of most of the administrative tasks of his job (faxing, emails, etc.) so I was being pressured to get out of the hospital by him. It took my six days of constant work whenever he wasn't using his laptop to catch up on what I missed while I was in the hospital.

I lost a little bit of my big toe joint to that a few years ago.

Yeah, be careful. This April my podiatrist cut two little holes in my feet two days before I was going for pacemaker surgery. Those two little holes became infected. And then the hospital, while trying to deal with this, gave me FIVE different scans (head, chest, legs, blah blah) and the dye in the scans damaged my kidneys. I spent two weeks in rehab healing from all that. Just because of two dime-sized holes in my feet.

My dad swore he had “diabetic tendencies” for years and had a doctor that ignored the early signs of diabetes.

Years later, after not taking care of his sugars, he walked on hot (not cool) cool decking next to a pool in July in Phoenix. He had full thickness burns to both feel. What followed was years of wound care, removal of individual bones when osteomyelitis would set in, and always a sense of “what’s next?”

later, life included taking half a foot, and then his entire lower leg, and eventually his passing because he could not fight of the infections.

Diabetes is a nasty disease that affects every part of the body. In his case the lack of blood flow and poor sugar control led to poor healing, which is incredibly common. I was working as an EMT and later in PA school while watching all of this happen. I couldn’t do anything to stop it because it was too late by the time I knew anything about medicine. Sadly, we lost him at age 57 when I was 6 months pregnant with his only grandchild due to infection in his dialysis catheter.

I am pretty militant about diabetes with my patients due to this experience because it was avoidable. I’m sorry if this lands heavy. I’m always willing to talk to people about how to control it, keep sugars in check, etc.
Feel free to DM me if you’d like to chat

Glucose in the blood causes the capillaries to become clogged. The tissue dies without oxygen. The toe may turn black and
has to be amputated. Diabetes also causes numbness in the feet and so protecting your feet is important. Always wear shoes.
Some rules to prevent amputation: no smoking. Blood glucose in normal limits. Protect those feet.

The doctor explained then how important glucose (blood sugar) control was.
He pointed out that infections need fuel to grow, and that fuel in the body is sugar. So a routine sore for someone else can be inhibited from healing due to excess sugar in the body. And the circulation is slower in the extremities, meaning fewer white blood cells to heal the wound.

My daughter took over management of her diabetes before she hit her teen years. Checking her blood sugar, calculating carb ratios and intakes and giving herself thousands of shots. Now she wears a Continuous Glucose Meter that reads her levels every few minutes and lets her know of trends and whether she is getting high or low. It all runs through her smart phone, and even calculates her background insulin amounts and any extra she needs when the glucose is increasing without shots. Both the insulin pump and her CGM are attached to her, and replaced every few days.

From the time she was about ten she said she wanted to be a diabetes nurse. She started two years ago at the biggest hospital chain in a city of 700,000 people, and was promoted last year to Inpatient Diabetes Educator. That means she is the nurse who does for newly diagnosed patients (90% are pre-puberty) what a nurse did for her about two decades ago.
She makes a great salary and does what she really loves and cares about, and her Dad couldn't be prouder of her.

Kudos on taking control of her own type 1 and a big hurrah for being a certified diabetes educator.

We don't have any in our region.