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    Foot ulcers
    granvillem posted:
    My blood sugar levels are decent (at home checks about 130, last A1C 6.4) but I still get open sores on my feet that seem to take forever to heal. The latest one opened in January and is still bleeding even though I clean and bandage it every day. My podiatrist examines it biweekly and says it is improving, but it has gotten infected several times resulting in trips to the ER and antibiotics. Short of amputation, is there another treatment I could be pursuing rather than just waiting for it to heal on its own? Those are the only two options that have been presented to me.
    nutrijoy responded:

    I thought that it might serve a useful purpose to put your statement in a graphic to emphasize the extremely serious nature of the options you have been presented with. An A1c of "only" 6.4 represents satisfactory control by contemporary protocols but I had experienced severe neuropathy when my own A1c measured only 6.1. Dr. Richard K. Bernstein , in one of his monthly webcasts, stated that he had one patient (female) who suffered from serious neuropathy issues when her A1c measured only 5.6 (yikes! It only shows that we are all different). In any case, poor glucose control leading to impaired wound healing is the number one cause of foot ulcers in diabetics. The monkey wrench in that statement is that current protocols define "good" or satisfactory glucose control as any A1c value "under 7.0". For some diabetics (a minority, I might add), that does work and they may go through life without developing any detectable complications. For others, like me (and possibly yourself), who are more sensitive to gluco-toxicity, we may develop all kinds of symptoms that, if not treated aggressively, can develop into more serious complications. Dr. Bernstein is a leading proponent of normalizing blood sugars in diabetics (that's true normal; not the vague pie-in-the-sky "under 7.0" value). He has stated that he has been successful in preventing amputations in patients simply by aggressive correction of the underlying cause, poor glucose control. I was able to heal my own neuropathy-related problems by normalizing my blood sugars (lowering my A1c to 5.2 and eventually to 4. but my problems were never as serious as what you are experiencing. If you need an incentive, be aware that the average survival period following an amputation is only 2 years, 4 months. Some patients live quite a bit longer and some less depending upon other health conditions/factors they may have. But those are the grim statistics.

    It might be beneficial for you to read Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars . It is available in both hard copy and ebook formats. You can start by reading selected chapters (from an earlier edition) online for free at the links provided . BTW, I was NOT able to normalize my own blood sugars using diet, exercise and oral medication alone. I had to resort to the use of insulin to attain the "true normal" control/levels that I desired. However, that path carries the risk of hypoglycemia if you are not properly trained in its use. Talk to your doctor first. Seek additional information from others who have been in your situation. Here are a few additional articles that may be useful or of interest:
    1. Diabetic Foot Ulcers (American Family Physicians)
    2. How To Prevent Diabetes Foot Pain and Avoid A Leg Amputation (Diabetes Treatment Guide)
    3. Tips To Prevent Amputation of Diabetic Foot (Diabetes Treatment Guide)
    4. Steps You Can Take to Prevent Foot Amputation (DiabetesHealth)
    There are tons more but the above should provide a good beginning. Remember, good diabetes control is an ongoing journey and not a destination. I learn something new about my own diabetes and make continuing adjustments in my self-care, diet, and activity levels. There is danger and risk in relying solely on a healthcare provider alone and a patient must take a proactive role for best results.
    nosce te ipsum
    Anon_1092 responded:
    I think I would be looking for a referral to a wound care specialist. A podiatrist is good but the wound care specialist may talk about different treatments that the podiatrist may not be able to offer. I think you have other options.

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