After performing additional tests and reviewing the results of Stewart’s medical records, the physician determines that the only course of action is to amputate Stewart’s leg.

The physician explains to Stewart that as a result of his poor type 2 diabetes management, high calorie diet, lack of exercise and high blood pressure, he developed peripheral neuropathy – a type of nerve damage that can cause insensitivity to pain, numbness and muscle weakness. Combined with poor circulation from peripheral arterial disease, the ulcer was not able to heal properly and became gangrenous.

The physician informs Stewart that if an infection from gangrene gets into the blood, he may develop sepsis and go into septic shock; which can be life-threatening. Because of the severity of his gangrenous ulcer, the only option is amputation. The physician explains that a surgeon will remove the damaged tissue and preserve as much healthy tissue as possible. After surgery, Stewart will be monitored in the hospital for ten days. However, it may take four to eight weeks for the wound to heal completely. Once the surgery is performed, Stewart will have to learn to walk with crutches because at this time, it is unknown if a prosthesis can be fitted to replace his leg.

The physician reminds Stewart that he must – it is a life or death issue – become more diligent in treating his type 2 diabetes, by developing a healthy lifestyle. He needs to monitor his blood glucose, take all medications, eat healthier, be active and check his foot for new ulcers. In addition, he must care for his mental health because diabetes and mental health are often related. Self-care activities such as listening to music, spending time with family, deep breathing exercises, and journaling can help him improve his mood and relax. Without including these activities he could experience more nerve damage; heart disease or stroke; blindness and kidney failure.

  1. Internet Research: Summarize how diabetes has led to amputation in Stewart’s case.

  2. Team Reflection: Stewart has a career as a truck driver. How could the amputation of his leg affect his career? How could this affect his family financially?

  3. Team Reflection: At the beginning of Stewart’s story, his physical limitations were discussed. What new challenges could he face in his daily activities?

    Team Reflection: How will Stewart’s medical condition affect his mental well-being?

  4. Internet Research: Answer True or False and explain why.
    1. Type 2 diabetes is preventable, type 1 is not.
    2. Eating too much sugar causes type 2 diabetes.
    3. Type 2 diabetes is a disease caused by the inability to regulate insulin.
    4. All people with type 2 diabetes need daily injections.
    5. Diabetes can cause blindness.
    6. Diabetes is hereditary.