Managing Diabetes: Check Behaviors to Reduce the Risk of Foot Ulcers and Prevent Limb Loss

An in-depth look at self-care behaviors for diabetes patients, from controlling blood sugar with the 2:1:1 dietary formula and appropriate exercise to stress management, aimed at preventing and promoting healing of diabetic foot ulcers, thereby reducing infection risk and foot amputation.

The key to preventing "diabetic foot ulcers" is maintaining stable blood sugar levels. Persistent high sugar damages nerves and blood vessels, leading to loss of sensation and easy ulcer formation. Therefore, behavioral adjustments from diet to mental health are essential and must not be overlooked.

Controlling blood sugar: The first line of defense against diabetic foot ulcers

The most important factor in treating and preventing diabetic foot ulcers is keeping blood sugar within target ranges, as appropriate sugar levels help wounds heal faster and reduce infection risks that could lead to limb loss. The standard targets are as follows:

• Glycated hemoglobin (A1c): No higher than 7%
• Fasting blood sugar: 80-130 mg/dL
• Blood sugar 2 hours after eating: No higher than 180 mg/dL

Adjusting diet with the "2:1:1" formula

Food choices directly affect blood sugar. Experts recommend a healthy plate proportioned as 2:1:1 (on a 9-inch plate) as follows:

• Vegetables 2 parts: Choose a variety of fresh or cooked vegetables
• Rice/carbohydrates 1 part: Focus on unrefined complex carbs like brown rice, germ rice, or whole wheat bread
• Protein 1 part: Emphasize low-fat meats such as fishChicken breastor tofu
• Caution: Avoid foods high in sugar, white refined flour, and saturated fats from fried foods or pastries. Instead, consume healthy fats from deep-sea fish or rice bran oil.

Exercise and proper medication use

Physical activity improves blood sugar control but requires special attention to foot care.

• Frequency: Exercise at least 150 minutes per week
• Movement: Avoid sitting continuously for more than 30–60 minutes
• Foot safety: Always wear properly fitting shoes suitable for foot shape and avoid activities that risk foot injury
• Medication discipline: Take medications or insulin in coordination with meals as prescribed by a doctor and never stop medication without medical advice.

Caring for the "mind" to prevent stress-induced sugar spikes

Chronic stress directly raises blood sugar levels. Patients should engage in relaxation activities such as meditation, yoga, or hobbies they enjoy. If feeling prolonged depression or anxiety, they should consult specialists for appropriate therapy.

Caring for diabetic feet goes beyond wound cleaning or foot checks; it involves systematically adjusting lifestyle habits including diet, exercise, and mental care. Consistent adherence not only speeds wound healing but also restores long-term quality of life for patients.

Reference source: Nursing Department, Ramathibodi Hospital