Abstract
We hypothesized that improved nutrition could improve the healing of diabetic neuropathic ulcers. Using a diabetes specific nutritional formula we obtained healing in a very short time in the first three consecutive cases of unremitting ulcer of more than 90 days duration. Pressure ulcers of the feet are frequent in the neuropathic diabetic population and the healing is extremely slow and painstaking with frequent relapses and high costs.1 Among the numerous reasons behind the slow reaction of the tissues is the wasting of the subcutaneous tissue and the dryness of the skin, partly explained by the catabolic state of uncompensated diabetes.We hypothesized that improving nutrition might be useful. We decided to add a diabetes specific formula with high nutritional value (Glucerna@Select), 500 ml/day, enriched with 24 key vitamins and minerals, and 20% cal from protein, 49% from Fat (32.2% MUFA and 9.7% PUFA) and 31% slow release CHO in 3 consecutive diabetic subjects who had an unremitting neuropathic ulcer for > 3 months and were considered a failure. The subject were in acceptable metabolic control with HbA1c < 7.3%. All patients underwent a Body Bioimpedensiometric Analysis to measure the total body water (TBW) and its partition into intracellular (ICW) and extracellular (ECW) water before the start of Glucerna@Select and at the time of healing.
Published Version
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