What is a reason that transplanted patients with diabetes may undergo limb amputation more frequently than dialysis patients with diabetes?

Transplanted patients with diabetes may undergo limb amputation more frequently than dialysis patients with diabetes primarily due to the complications arising from steroid use. Steroids, which are commonly prescribed to prevent transplant rejection, can greatly impact the patient's overall health. One significant effect of steroids is the exacerbation of infection and peripheral vascular disease, which are already common complications in diabetic patients.

Infections can become more severe and harder to manage in transplant recipients due to the immunosuppressive nature of these medications, making it more likely for infections in the feet or other extremities to progress to a point where amputation becomes necessary. Additionally, peripheral vascular disease reduces blood flow to the extremities, compounding the risk of tissue damage and subsequent need for amputation. Thus, the use of steroids in transplanted diabetic patients contributes to an overall higher incidence of limb complications and amputations compared to those on dialysis.