**3. The effects of diet on diabetic foot ulcers**

There are two prevailing and compelling theories of obesity and diabetes, but they are somewhat opposing theories neither of which explains entirely the complexity of obesity and glycemic control [28, 29]. The first is called the energy balance model (EBM) and the carbohydrate-insulin model (CIM). Although most scientists may be in favor of the EBM, the recent studies on the CIM and the effect and results of a low carbohydrate diet are compelling. Depending on the strategy of each model, determines the diet that would work best. Diets can influence incretin release and provide the proper amounts of SCFAs (see **Figure 1**).

Less than 10% of all diabetic patients have type I diabetes or similar atypical diabetic diseases. Type I diabetic patients should already be on a special diet to help control their blood glucose levels. One should monitor the intake of carbohydrates and concentrate on low glycemic foods and beverages. One should be aware that sugar-free foods and beverages do not necessarily mean carbohydrate free. Patients that fall into this category have diabetes because their pancreas beta cells do not produce sufficient amounts of insulin [30] to regulate their blood glucose levels. But there is no one meal plan that fits all. For TTDM patients, insulin insensitivity is the problem, and to relieve those symptoms usually a reduction in weight is necessary. This means a reduction in calorie intake, especially of dense energy foods such as fatty foods, and perhaps even lifestyle change.

Diabetes diets are certainly important and those that have diabetic symptoms should follow these guidelines. A carbohydrate-reduced diet is recommended but carbohydrates are found in many foods with grains such as bread, pasta, milk, any sweets that contain processed sugars, fruit, and even some vegetables that are high in
