![]() Carbohydrate daily recommendations will vary from patient to patient based on maturity of T2DM, daily glycemic control and if patient is on insulin therapy or oral hypoglycemics.Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid, are fatty acids that contribute to membrane fluidity, membrane and intracellular signals, and the modulation of apoptotic pathways.Important fats to consider are mono and poly-unsaturated fatty acids that play a major role in cell membranes.Only in patients of low BMI will it likely be necessary to set specific minimal caloric goals.In a patient with elevated BMI and poor diabetes management, one should minimize energy intake while optimizing protein intake.For patients who have poor glycemic control and/or diabetes their carbohydrate requirements will require focused attention throughout treatment.Both fats and carbohydrates help support inflammatory response, cellular activity, angiogenesis, and collagen deposition in the proliferative phase of healing process.Carbohydrates and fats provide a patient’s energy needs.Is involved in interactions between enzymes which remodel the extracellular matrix, including matrix metalloproteinases and their tissue inhibitors. ![]() Modifies cellular activities to optimize mitogenesis, differentiation and migration.Provides tensile strength in the healing wound.Collagen is the major protein of scar tissues that: Protein intake is particularly important for collagen production.Quality of protein consumed is also important to provide adequate essential amino acids which cannot be synthesized in the human body.Many guidelines recommend 1.25–1.5 g/kg body weight per day of protein for malnourished patients with pressure injuries.Increased protein levels have been linked to improved wound healing rates.Protein is important in all stages of the healing process from hemostasis to remodeling.These amino acids build and repair muscle, skin tissues, hormones, and enzymes, and help to regulate fluid balance and promotes positive nitrogen balance.Protein intake is essential to provide amino acids for optimized wound healing.Instead, use “foot ulcer”, “ulcer of the foot as a result of diabetes” or similar. This guide uses the term “diabetic foot ulcer” for simplicity, however the phrase should be avoided when speaking with patients.This gives the impression that a person is being labeled as their disease. Avoid using the word "diabetic" as a noun, as well as labeling someone “a diabetic person”. ![]()
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