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

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.