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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7 Laboratory Evaluation Among the standard laboratory studies, several should be considered: • HbA1c should be obtained to determine diabetes control and carbohydrate intake. • A complete blood count (CBC) may identify a nutritional anemia. ▶ Microcytic hypochromic anemia may indicate iron deficiency. Macrocytic anemia may indicate folate or B12 deficiency. • Total lymphocyte count may be a useful index of overall nutritional health. • Albumin and prealbumin are often ignored as nutritional indicators because they are susceptible to change by metabolic stress such as infection or trauma and may therefore give confusing information about nutrition. ▶ Whatever the source of a low albumin and prealbumin, one should determine the cause and address it to optimize healing. • If the history and physical exam indicate micronutrient deficiencies, specific tests may be ordered. Table 3. Risk Factors for Ulcer Development 1. Medical history 2. Age 3. Weight 4. Risk assessment tool results (e.g., Braden Scale) 5. Current medications and comorbidities 6. Ability to meet nutritional needs independently 7. Oral problems (e.g., trouble chewing or swallowing) Comorbidities • Medical problems that interfere with eating such as bowel disorders should be identified. • Other disease states such as recurrent infections or cancer increase nutritional requirements and may lead to malnutrition.

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