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Geministar

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Hi, I developed a blister on my second toe which within days became a dark purple color. I went to A&E where I discovered I was diabetic (T2) and had a diabetic ulcer!! There seemed to be a concentration on the blood glucose and less care re the toe and ended up being admitted to hospital as there was cellulitis around the ulcer. Intravenous antibiotics for three days and then vascular surgeon came to see me and suggested amputation. I was stunned because tests revealed good pedal pulse, good blood flow and feeling in toes. Toe hadn't been dressed for for days and wasn't debrided, I feel the ulcer hasn't had chance to heal before being called a non healing ulcer after ten days.

Anyway i wanted to try and heal toe, am currently working on that. Taking 3 x 500mg metformin levels between 6.4 to 12. Mostly below 9 and eating low carb.

Anyway got any advice please?
 
Hi Geministar and welcome!
First let me tag in @daisy1 for her useful info post.
I’m so sorry to hear about your toe and agree ten days seems premature to give up on thinking your toe might heal. Can you give us an example of what you eat in a typical day to see if we can tweak things to improve your numbers?
I had major surgery on my foot last Xmas with my blood sugars under control and had no trouble healing. I hope your foot can heal too.
 
Hi Rachox, I'm still trying to work out food in that I've only been diagnosed for three weeks now. However bread ( even multigrain) sends my numbers up, I'm generally having low carb less than 15g per meal, I've lost 5kg in weight so far. I'm due to have another HBA1c at the end of January, my previous one was 136 on diagnosis, though they think the raging infection contributed to that being so high.
 
Hi Rachox, I'm still trying to work out food in that I've only been diagnosed for three weeks now. However bread ( even multigrain) sends my numbers up, I'm generally having low carb less than 15g per meal, I've lost 5kg in weight so far. I'm due to have another HBA1c at the end of January, my previous one was 136 on diagnosis, though they think the raging infection contributed to that being so high.

Hi Gemini, can you be more precise and list the actual foods?, I know that helps people to comment.
 
For breakfast an egg or a one egg mushroom omelette
Lunch salad or carrot and kumera Thai salad
Dinner chicken breast, 2 baby potatoes in skin, carrots, broccoli, cauliflower and gravy
 
My diagnosis also came after a non healing blister on a toe (3rd) that was beginning to show signs of secondary infection - in my case the Gp ignored my reports of diabetic symptoms and request to be tested for diabetes, saying he’d only do it once the blister had healed - which it never did
I was ultimately bluelighted to hospital with a raging infection and BG’s in the high twenties so I was put onto an insulin pump
The surgical team on duty that night decided to try to save my foot although I was told by nursing staff that had any of the other 3 teams been on duty, they would have immediately done a below the knee leg amputation.
It took a 4 month stay in hospital to get everything healed up - MRSA aqquired in hospital delayed things and also ate away some of the bone in the original toe that had the blister. 10 years later, that toe shattered in a head on car accident so had to be amputated because it reset at right angles - the amputation was quite a simple proceedure done under a local aneasthetic and healed up fine
I suppose what I would say is
1) surgeons arent always the best judges of what will / will not heal for a diabetic
2) things get a whole lot more complicated and dangerous if you get an infection in the ulcer and / or if your BG control is sketchy - be very careful with both
3) having a toe amputated is not as major a procedure as it sounds and with a combination of good BG control and circulation can heal well and very quickly - think I was off work for 2 weeks
4) toes are not essential for walking / balance (except maybe for 2 - the big and little toes)
 
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For breakfast an egg or a one egg mushroom omelette
Lunch salad or carrot and kumera Thai salad
Dinner chicken breast, 2 baby potatoes in skin, carrots, broccoli, cauliflower and gravy

Ok on the whole that looks good apart from potatoes and if Google is right your salad has sweet potatoes in it, both of those are high carb. Carrots aren’t the best choice either but you may get away with a small portion. Gravy may be too much carb if it’s thickened with flour. You need to do some methodical testing to see if your meal choices are raising your blood sugars Test right before you eat and then 2 hours after your first bite. You are looking for a rise of no more than 2 mmol/l. Here’s a table of recommended levels:
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
 
@Geministar
Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
Thank you so much I have a lot to learn. Already feeling so much better though after the extreme fatigue before diagnosis. I'll refine the diet and step up the exercise when (if) my toe heals.
 
You could try Ginko Biloba tablets - they increase circulation and are useful - the next thing to try would be leaches (Not kidding) as they use a vaso dilator - old wives used to save lives - the women in my father's family used to be nurses and midwives and were thought to have unnatural powers due to their saving lives and limbs when the doctors had no remedies other than cutting off.
 
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