After years of improvements in diabetes management, a new study shows a recent upswing in the number of lower limb amputations.

The study, which was published on Tuesday in the Canadian Medical Journal, examined data from more than 20,000 people who underwent amputations in Ontario between 2005 and 2016. While there was an initial decrease in amputations leading up to 2010, by 2016, that decline had reversed in people ages 40 and up.

“There was approximately 15 per cent increase in the number of those amputations over the last 10 years,” said Dr. Charles de Mestral, a vascular surgeon and author of the study.

Erin Caron, 61, lost her right leg mid-shin nine years ago. The toes of her right foot were also amputated four years ago.

“I think like a lot of people ‘it was never going to happen to me,’” she said.

As a health care worker, she wasn’t careless about her diabetes management, but she does describe herself as rather “care-free” about it.

“It’s frustrating,” de Mestral said. “Because many of those amputations are likely preventable so to me this is a wakeup call for all Ontarians and also for doctors like myself that we need to do better in terms of foot care and preventing amputations related to diabetes and poor circulation”

In addition to the disfigurement and loss of mobility, the researcher notes the feeling of loss puts patients at a higher risk for depression.

Caron and her husband Mike had to move from Scarborough to the Campbellford area. They were lucky to find a home that was already wheelchair accessible, but she says her amputations have taken a toll on the social and emotional well-being of herself and her husband.

“It’s very isolating at times, that’s what I find,” she said. “We just don’t go anywhere anymore. It’s too difficult to go into people’s houses with the wheelchair and walker and all the paraphernalia you have to take.”

De Mestral said there has been an increase in patients with diabetes overall, which puts a greater number of people at risk.

“And we know that people with diabetes have about a 15-20 per cent chance of developing a wound on their foot so that increase is definitely a contributing to a rise in amputations. Also an aging population with a greater number of people with peripheral arterial disease or poor circulation in their legs may be contributing.”

He urged patients with diabetes or with poor circulation to check their feet every day. And that starts the day you are diagnosed, he says.