ALPS - Nutrition Interventions in Adults with Diabetic Foot Ulcers

Nutrition In DFU Guidelines Advisory Pocket Guide

ALPS Nutrition Interventions in Diabetic Foot GUIDELINES Advisory - brought to you courtesy of Guideline Central.

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2 Introduction Prevalence • Diabetic foot ulcers (DFU) are chronic wounds in the foot or feet associated with neuropathy and/or peripheral artery disease (PAD) of the lower limb in patients with diabetes mellitus. • Reports from the Centers for Disease Control and Prevention show that in the United States there are nearly one in four adults living with diabetes, which indicates that a large number of Americans are at risk of DFU. • DFUs will develop in up to 34% of patients with diabetes at some time in in their lives, and of those, approximately 15%–25% will require an amputation. • Moderate or severe malnutrition has been identified in over half of patients with DFU, and malnutrition in DFU is correlated with increased lower- extremity amputation. • Improvements in wound care therapy, including nutrition interventions, can reduce the financial burden of DFUs and increase life expectancy and quality of life. Challenges and Goals • There is no internationally agreed upon standardized definition of malnutrition, neither for protein energy malnutrition nor for micronutrient deficiency, in the context of chronic wounds or in DFU. • There is a lack of high-quality randomized controlled trials to evaluate the benefits of nutritional supplementation in DFU, and existing studies use a wide range of outcome variables. • Ensuring patient compliance when it comes to nutrition can be notoriously challenging. • However, there is a clear correlation between nutritional status and healing, and as such, a balanced diet with adequate fluids, calories, proteins, and nutrients is fundamental to the healing process. • The following guidelines are designed to assist the clinician to accomplish the difficult goal of improved outpatient nutrition to support the healing DFU wound. • We recommend that you use your clinical judgement as every patient case is unique. The nutrition plan should be individualized based on disease state and/or risk of malnutrition.

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