Scurvy is now presumed to be an uncommon disease in developed nations. In a two year period at Westmead Hospital, we saw three cases of vitamin C deficiency associated with delayed healing of diabetic foot ulcers.

The first case is a 51 year old female with a seven year history of type 2 diabetes who presented with two leg ulcers of eight months duration. Vitamin C level was identified to be low at 10 umol/L (normal range: 40-100 umol/L). The patient reported no fruits in her diet, and vegetables containing vitamin C were boiled excessively. Vitamin C supplementation was started and within three months the leg ulcers healed.

The second case is an 80 year old male with a two year history of type 2 diabetes who presented with a neuropathic ulcer over the first toe of three months duration. His diet contained minimal fruits and vegetables. Vitamin C level was low at 23 umol/L and the patient began Vitamin C supplements. Within four months the ulcer healed completely.

The third case is a 64 year old male with a fifteen year history of type 2 diabetes with multiple complications. Three months after recurrence of a right mid-foot ulcer, Vitamin C level was low at 4 umol/L. The patient revealed minimal intake of fruit and vegetables and did not increase dietary vitamin C intake despite dietary advice, and the ulcer did not improve. With further advice and initiation of supplements, the Vitamin C level improved, as did the ulcer.

It is unusual to see scurvy in a suburban western community, particularly amongst patients who have received advice on diet for management of diabetes. Vitamin C deficiency is characterised by poor healing of wounds therefore it should be considered in patients with diabetes and chronic leg ulcers as Vitamin C supplementation is easy to administer.