175643 Nutritional Assessment of the Chronic, Non-Healing Diabetic Wound Patient

Tuesday, October 28, 2008: 12:30 PM

Emily Marie Splichal, DPM , New York College of Podiatric Medicine, New York, NY
Although people with diabetes comprises only 4.5% of the U.S. population, last year alone the United States healthcare system spent and astounding $100 billion dollars on diabetic complications. The chronic complications associated with diabetes account for a majority of this expenditure, with diabetic foot ulcers being the most common reason for hospitalization. Diabetic foot ulcers are estimated to occur in roughly 15% of diabetic patients, with 85% of these ulcers leading to amputation.

Despite the existence of algorithmic management of diabetic ulcers, many diabetics still present with chronic, non-healing ulcers. A chronic wound results when the normal repair process is interrupted or there are insufficient nutrients and oxygen locally at the ulcer site. These non-healing wounds are a challenge to the patient, physician and healthcare system thus necessitating the need to look at all possible causes for impaired wound healing in the diabetic patient.

Healing is influenced by poor nutritional status which includes inadequate vitamin requirements, excessive methionine and AGE's and insufficient caloric intake. Nutritional assessment of the diabetic patient with a non-healing ulcer is an essential piece to the puzzle of solving why chronic wounds are non-healing. Learn how a diabetic diet can uniquely impair their wound healing and how we as podiatrists can assess for possible vitamin supplementation or work with a nutritionist to reduce chronic ulcers and possible amputations in our patients.

Learning Objectives:
1. Describe the difference between acute and diabetic wounds 2. List the phases of wound healing and describe what nutritional requirements are needed for each phase 3. Discuss why podiatrists need to consider nutrition in diabetic wound patients 4. Describe hyperhomocysteinemia and its impact on wound healing 5. Recognize if diabetic patients need nutritional supplementation to improve wound healing

Keywords: Diabetes, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Researcher
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.