Profile of Blood Glucose in Diabetic Patient Suffered from Diabetic Foot Osteomyelitis with Effective Low Carbohydrate Diet

*Corresponding author: Hiroshi Bando*, Yoshiro Abe,Kazuki Sakamoto, Shigeki Hatakeyama, Keisuke Yagi, Toshiharu Kobayashi, Tomoya Ogawa, Noboru Iwatsuki, Mitsuru Itagaki, Kaori Ashikaga and Yukari Matsumoto

Abstract

The case was 52-year-old female with type 2 diabetes mellitus (T2DM) for 10-years. She complained of the decreased sensation of right lower foot, and revealed diabetic foot infection (DFI) and/or diabetic foot osteomyelitis (DFO) at right 1st proximal phalanx. Various data included body mass index (BMI) 33.3 kg/m2, HbA1c 11.4%, blood glucose 430 mg/dL, WBC 12100 /μL, C-reactive Protein (CRP) 13.5 mg/dL. On admission (day 1), she was started by 4 times of injection (Aspart and Glargin) with glucose profile 200-500 mg/dL. Surgical amputation of the right toe was performed between 1st metatarsal and proximal phalanx (day 17). Then, blood glucose profile decreased moderately. After discharge of the hospital, super-Low Carbohydrate Diet (LCD) was started without Aspart (day 37). Consequently, glucose profile was normalized with HbA1c 6.3% on (day 77). Consequently, LCD was evaluated to be effective for glucose variability in this case and some related discussion was described.

Keywords

Diabetic foot infection (DFI); Diabetic foot osteomyelitis (DFO); Low Carbohydrate Diet (LCD); Japanese LCD promotion association (JLCDPA); International Working Group on the Diabetic Foot (IWGDF).

Abbreviations

DFI: Diabetic foot infection; DFO: Diabetic foot osteomyelitis; LCD: Low carbohydrate diet; JLCDPA: Japanese LCD promotion association; IWGDF: International Working Group on the Diabetic Foot.