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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10 Dietary Factors in Healing and Specific Nutrients Calories • Caloric needs are high when a diabetic foot ulcer is present. Calories provide energy to aid in wound healing and energy demand increases with the patient's nutrition risk factors and the severity of wound(s). ▶ Adequate energ y aids in collagen formation, anabolism, cell metabolism, and development of new tissue such as blood vessels. • Generally, the recommended daily calorie intake is 2,000 for women and 2,500 for men. • Overweight patients with a BMI >30 are at risk of malnutrition, yet patients with significant unintentional weight loss over a specific amount of time are also at risk. • Conducting 24-hour recalls and food frequency questionnaires should be practiced at every visit when treating a patient to ensure the patient is meeting estimated caloric needs. • Utilize indirect calorimetry as the gold standard for identifying energy needs. If indirect calorimetry is not available, there are other formulas that can provide a standard starting point. Table 5. Kcal Recommendations BMI Range Kcal Recommendations <30, or under 130% of IBW 25–30 kcal of ABW 30–50 11–14 kcal per kg of ABW >50 22–25 kcal per kg of IBW ABW, actual body weight; BMI, body mass index; IBW, ideal body weight Macronutrients • Carbohydrates, protein, and fats are the three essential food groups known as macronutrients. • Specific macronutrient needs are high when a patient has a DFU, especially if the patient is malnourished or is at risk of malnutrition, because the body may be at or close to a catabolic state. • When in a catabolic state, the body will utilize its own skeletal muscle as its energy source. This results in a loss of lean body mass and worsening of the patient's wound healing process.

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