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Foot ulcers

MauraH

MauraH

Well-Known Member
Messages
64
Location
Canada
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone, I have a foot ulcer that is taking its time to get healed. It started as a blister on my ankle although there were no new shoes or friction, etc. It's infected and now I'm on heavy duty antibiotics.

The thing is I have been diagnosed only 6 months and I got my A1C down to 5.6 very quickly due to low carbing. Is the low carbing causing the problem? I thought your glucose had to be uncontrolled and high for complications to develop. Needless to say, hobbling about is no fun and the whole situation is scary based on what I've read about diabetic foot problems. Any advice is appreciated and I hope everyone is doing well as we edge into the holidays.
 
Have you had the ulcer looked at by your GP/Podiatrist?
 
Congratulations on getting such good results on your HbA1c!

Sometimes there can be damage before we are diagnosed, and before we address our diet and the HbA1c. Good job you got it under control when you did! Please don't slack off now - uncontrolled or raised blood glucose will do your ulcer no good at all.

And yes, I agree with the others - please get someone else to have a look at your ulcer. A second opinion is always good.

(a friend of mine was told he had a mosquito bite on his foot. another doc diagnosed it as gout. It was the gout. They don't always get it right!)
 
My GP looked at it after dismissing the blister and recommending polysporin. I had a feeling it was bad news because who gets a blister on their ankle for no reason. She prescribed the antibiotics and it is improving very slowly. I see her again on Wednesday and am going to press for a referral to the wound care clinic. But she doesn't take diabetes very seriously and I don't see my endocrinologist til February. I doubt she'll give me the referral as it is improving and I'm still on the antibiotics.

My concern is that I have the thing at all. I was pre-diabetic a year ago, diagnosed six months ago, good control very quickly, and now this.
 
That sounds like a very sensible thing to do @MauraH, do let us know how you get on.
 
Brunneria said:
Congratulations on getting such good results on your HbA1c!

Sometimes there can be damage before we are diagnosed, and before we address our diet and the HbA1c. Good job you got it under control when you did! Please don't slack off now - uncontrolled or raised blood glucose will do your ulcer no good at all.

And yes, I agree with the others - please get someone else to have a look at your ulcer. A second opinion is always good.

(a friend of mine was told he had a mosquito bite on his foot. another doc diagnosed it as gout. It was the gout. They don't always get it right!)
Click to expand...
Hi Brenneria,
How long have you been ketogenic? I was low carbing, then switched over to the Bernstein diet which meant even lower carbs, got the ulcer pretty quick, and then I wondered if the ketogenic diet could have caused the ulcer? I ask this because it must be something other than glucose, those numbers being low, even at diagnosis (A1C of 7.1).
And thanks for the encouragement! I appreciate it.
 
I've been keto for a couple of years now.
Was low carb for about 20 yrs before that (with the odd 'holiday' ;) )

My experience with being ketogenic has been consistently good - but some people don't get on with it.

Can i ask, has your keto diet been what is known as 'well formulated'?
By that, i mean good quality protein (not too much processed), plenty of non starchy salad and veg, in different colours, good fats (not processed, not veg oils, with plenty of omega 3s). Supplements, if necessary? Etc.

I am not trying to criticise or critique your eating, i am just checking you have been eating a varied, nutritional diet... And it is so easy to fall into any number of innocent pitfalls when you start out...
 
Good questions. I found the diet monotonous: lots of beef, eggs, chicken, shrimp occasionally; minimal potatoes; leafy salad at every meal; almond butter or Kind bars (low carb) for snacks; minimal fruit--ground Cherries, blueberries. I ate a seed-based high fibre cereal called Holy **** very morning and got my numbers down. Lots of 5s. Switching to Bernstein, I kind of combined it with Palio and my cream and cheese consumption went up. Veggies I eat are bell peppers, zucchini, cabbage, shallots, etc. I avoid tomatoes and all fruits except the two above.

I got some 4s on Bernstein. My weight is the same since the switching, about 118 lbs (had been 138) pre-diagnosis back in June.but I think the cheese is making me feel heavier. Also I've been eating less salads since its winter--cold"

I wonder what you think of all this? I got a bit scared off ketogenic when I got the ulcer. There seemed to be a correlation. Any advice is appreciated.
 
My understanding is that ulcers often develop in areas of the feet and legs that have poor blood supply, causing slow healing from injury, increased chance of infection and dying flesh. I think that while the injury can happen fast, the circumstances that allow the injury to develop (bad circulation, etc.) take years, if not decades to develop.

Raised blood glucose, over time, causes diabetic complications which often result in reduced blood supply with the same knock on effects of slow healing, fragile flesh, nerve damage.

I think any diet that was missing vital nutrients would make that situation worse, but I don't think that a well formulated ketogenic diet would be anything other than helpful in those circumstances.

Having said that, a badly formulated diet - of any kind - will make slow healing and infections more likely.

As an aside, I have also gone through bouts of boredom with ketogenic eating. But I don't have the option to come off the diet, since carbs make me feel so ill. So I mix it up with herbs, spices, we have curries and huge salads, various cheeses, low carb desserts, berries and cream... I eat 70% solid choc nearly every day (the antioxidants, don't you know ;) ) and think that I probably get more variety, rainbow eating and different tastes, than most people.

But - as you have already realised - I am a strong supporter of ketogenic eating. So I am biased. There are some people who swear blind that eating low carb will cause every illness known to man (or woman). :)
 
Hi everybody,
I saw my GP again today and this time the first thing she said was "I'm sending you to the wound care clinic." This was music to my ears. I had a phone consult with the wound care specialist nurse right away. The I go to the clinic first thing tomorrow morning and will get it properly dressed and all the dressing supplies I need for the Christmas holidays. The infection seems better but the ulcer is stubborn. I also went to get measured for compression socks and an ulcer liner as per the nurse's recommendation; the GP gave me the prescriptions for these things. The nurse thinks it is what she called a "poor circulation ulcer" rather than a "true diabetic ulcer," which would be slower to heal. She thinks proper wound care and compression socks will heal it. I feel so much better and can't wait to go to the clinic in the morning! Life with diabetes--the things that make you happy.
I think my GP learned something from this as she told me to come back right away if I even get a blister next time!
BTW, knowing the forum is here is such a comfort and I have learned so much from it.
 
Common sense has prevailed @MauraH, pleased you got your referral. Best wishes.
 
That is excellent news!
So pleased you have got it seen to, and have a positive prognosis.
Now you can relax and enjoy the next few days without worrying!
 
Brunneria said:
That is excellent news!
So pleased you have got it seen to, and have a positive prognosis.
Now you can relax and enjoy the next few days without worrying!
Click to expand...
Brunneria, Do you use Dr Bernstein's recipes? I'm gradually incorporating them into my diet.
 
MauraH said:
Brunneria, Do you use Dr Bernstein's recipes? I'm gradually incorporating them into my diet.
Click to expand...

I don't actually.
I was a bit alarmed when i read his book, about the austerity of his diet, and the liberal use of various sweeteners - which don't agree with me.

I do better if i keep my carbs to evenings (less insulin resistance then) so i tend to have almost none until after lunch. Seems to work for me. :)
 
Brunneria said:
I don't actually.
I was a bit alarmed when i read his book, about the austerity of his diet, and the liberal use of various sweeteners - which don't agree with me.

I do better if i keep my carbs to evenings (less insulin resistance then) so i tend to have almost none until after lunch. Seems to work for me. :)
Click to expand...
Agreed re the sweeteners. I avoid all kinds of all sweeteners and don't even think you can buy the ones he recommends here in Canada. I like his chili recipes and a couple of other savoury ones such as chicken in mushroom cream sauce. Am also looking through paleo books for recipes but many rely so much on cheese, which is fattening for me, and on bananas, which I can't even look at.
 
I had a good visit with the wound care clinic and, coincidentally, it is beginning to heal. I finish the antibiotics today. They gave me nice protective padded dressings, medicated swabsticks, etc. And they seem to "get" diabetes! Merry Christmas everyone!
 
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