diabetes sores on toes, will they get better?

[jhon99]

Hi my father aged 58, has developed diabetes sores on ALL his toes on both feet.

He is currently using Epaderm Emollient. And has been refereed to see a foot specialist in 3 weeks time.

He also suffers from diabetes related nerve damage in feet so can not walk for more then a few minutes. His blood glucose levels are under control for 95% of time (for the last 10 months) due to extremely strict, healthy, nutritious, diet. he doesn't drink, smoke, or eat any unhealthy food.

He looks after his feet, wears trainers in the house, washes his feet twice a day, so I am surprised he has got sores.

So my question to people who have experience of diabetes sores is;

1) will the sores get better i.e. completely vanish ?
2) or will things go down hill ? ie will organs start to fail, will he die?
what is the worst case scenario?

Any help or advice will be grateful


PLEASE BE BRUTALLY HONEST, DON'T BE DIPLOMATIC- .

 

[cugila]

Few questions for you.......

You say he is well controlled most of the time. Do you know firstly the HbA1c last time round.

Secondly, what are his BG levels throughout the day. Your previous posts don't give much information other than 5-6 I think. When is that ? Fasting, before meals, 2 hrs after meals .......???

You mention a healthy diet ? What sort of things does he eat ? Sometimes what might be thought healthy might NOT be for a Diabetic. All the things that you have mentioned would tend to indicate high Bg levels rather than 'well controlled.'

The information might help us to better answer you and offer some advice.

 

[Snodger]

1) will the sores get better i.e. completely vanish ?
2) or will things go down hill ? ie will organs start to fail, will he die?
what is the worst case scenario?

Any help or advice will be grateful


PLEASE BE BRUTALLY HONEST, DON'T BE DIPLOMATIC- .

I don't have personal experience of diabetic sores so I will wait for someone else to comment directly on that, but I do know that my 81 year old father (not diabetic) had blood vessel problems which caused a sore, we were worried it would never heal, but he has now managed to turn it around and get it healing following some changes in the way it was being dressed and looked after. It's worth making sure you hunt down a health care professional who knows about dressing this kind of long-term, tricky lesion.

Also, the fact he has sores doesn't automatically mean everything else is going to go wrong. If his nerves are damaged so he doesn't notice when he's hit/hurt his toes, it can be quite easy for foot problems to arise. It sounds as if he may have blood vessel damage too if healing is a problem, but that doesn't necessarily mean other things are damaged. It is a warning bell though - it's worth checking the other 'usual suspects' for complications. E.g. ensure he gets his eyes checked, get urine and blood tests done to check for damage to other organs, etc.
Here is the list of the 9 checks NICE says diabetics should have - you may already know all of this:
blood pressure
HbA1c (average blood sugar)
weight
urine test for albumin
serum creatinine (the ratio between albumin and creatinine is what they use to check kidney function)
serum cholesterol
assessment of eyes (including looking at the very back of the eye)
assessment feet (you already know there are problems on his feet)
checking if the patient smokes (you already know he doesn't)

hope that helps.

 

[jhon99]

Thanks for replying.

Few questions for you......

You say he is well controlled most of the time. Do you know firstly the HbA1c last time round.

Nope

Secondly, what are his BG levels throughout the day. Your previous posts don't give much information other than 5-6 I think. When is that ? Fasting, before meals, 2 hrs after meals .......???

2hrs after meals; he eats at 6pm and his sugar is high between 6 and 10 2 hours after eating but in the evenings about 9:30 its around 4. Is their anything he can do about this?

before meals in the mornings, and before he goes to sleep, his BG levels are between 4 and 6.

You mention a healthy diet ? What sort of things does he eat ? Sometimes what might be thought healthy might NOT be for a Diabetic. All the things that you have mentioned would tend to indicate high Bg levels rather than 'well controlled.'

he eats weetabix in the morning, 2 slices of brown bread at lunch times, boiled green lentils in the evening with 3 chapatis. and porridge before going to sleep. Few cups of tea without sugar, a banana and apple as snacks during the day.

he has been on this strict diet for 10 months and in that time his sugar is under control. Before he started this diet his sugar used to be up to 10.

The information might help us to better answer you and offer some advice.

So what do you think? Is this a long downward spiral or will the sores disappear.

 

[JUSTFOCUS]

Honestly no one can say it will or won't . Some diabetics never get it and sadly like myself do .I to have cleened and creamed my feet and i hate my diabetes for this . I used to swim alot i would'nt dare go to a public swimming pool even with them water resistant socks and now i'm in a wheel chair (not due to diabetes) my feet are even worse .It 's pot luck unfortunatly.
Good luck with your father JF

 

[viviennem]

Hi Jhon

I can't really help with diabetic sores - the only thing I know anything about is leg ulcers, which my father had. They are difficult to heal too.

It did occur to me, though - apparently plenty of foot problems, in everyone not just diabetics, can be caused by badly-fitting socks. My little toes are sort-of on sideways, and if I get a fold of sock or a toe-seam across the front of them it's excruciating and gives me blisters. I always wear socks with no toe seam now, and I like the slack topped ones as well, and the ones with thicker soles.

There's a good firm that specialises in diabetic socks etc - google 'cosyfeet' (and try not to be put off by the website!).

I hope your father manages to get his sores healed.

Viv 8)

 

[iHs]

Hi

If your dad is eating an Asian diet, he will need to carefully count the carbohydrate of everything that he eats and balance it with the right amount of insulin. Some of the stuff your dad is eating is fairly high in carb.

Regarding his foot problem, it's important to wear good quality socks made from cotton and not nylon and also with trainers; leather ones with a good cushion sole are ideal, preferably with air holes so that the foot can breathe. Plastic type trainers are terrible for causing all sorts of foot troubles.

Lastly, if these sores don't appear to get better, find a bee keeper who has bees in a hive and buy a jar of pure honey. Honey has remarkable healing properties and is seriously underestimated but does need to be bought from a bee keeper and not healthfood shop or supermarket.

 

[viviennem]

I agree about the honey, iHs - I had a friend who also had leg ulcers and it helped him.

Does mass-produced honey have nasties added, then? I've never read any of the labels, but then I always buy locally-produced honey. My father used to keep bees, so I was brought up on the real stuff - didn't stop me getting hay-fever and asthma, though, in my teens!

One honey myth is that it should be runny - it is when first produced, but it naturally crystallises, with age and with the cold, over winter. I don't know whether the big commercial firms make it crystallise artificially.

Diabetic-friendly honey would be nice!

Viv 8)

 

[LaughingHyena]

I don't think it's that the commercial honey has stuff added but it's usually been heated, to make filtering and bottling easier. I seem to remember it also stops it crystallising as fast.

I'm guessing that it also ends up reducing/removing the healing properties.

 

[viviennem]

Thanks, LaughingHyena. That would make sense.

Jhon, I've just had another look at your post about your father's diet. Where does he get his Vitamin C from? Vit C is quite important in the healing process, I believe. Does he take a supplement? It's worth discussing with his dietitian, to make sure he's getting everything he needs.

Let us know how he goes on.

Viv 8)