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Diabetic Wound Prevention Through Nutrition and Glycemic Control

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Diabetics are more prone to unnecessary wounds and poor healing of them because of a higher presence of glucose in the blood. High glucose levels in the blood can damage small blood vessels and excess glucose itself impedes the functionality of the white blood cells, one of the main powerhouses of disease and infection fighting. Damaged vessels mean poor circulation, which cuts off the pathways of nutrients and infection fighting cells to that wounded location.2 The most logical way to counteract these negative effects is to have good glycemic control. Eating low Glycemic Index (GI, rating of food on how fast or slow they raise blood glucose) carbohydrates, high quality proteins, and supporting nutritional supplements (eg. Glucerna for Diabetes) specifically designed for diabetics will help aid in diabetic wound prevention and glycemic control.1, 6

What is Glycemic Control?

The goal of glycemic control is to minimize symptoms related to hyperglycemia (e.g., tiredness, thirst, heart disease, cognitive impairment, depression)1, 3. A diabetic with good glycemic control should have an average of fasting blood glucose of 80 – 130 mg/dL.5 Control is not exclusive to one meal of the day and also not exclusive to food alone. The whole process requires a bit of work in knowing the GI value of each food, daily caloric intake, weekly meal planning, exercise routines, while making sure the blood glucose does not drop too low either (hypoglycemia). Since any type of function in the body requires energy, especially wound healing, choosing the right carbs is important. Carbs that are slow-release type, or slowly digestible are rough cut oats, whole wheat (stone-ground), beans, pears, oranges, apples, and non-starchy vegetables like broccoli, cauliflower, and asparagus.1, 3

How Protein Helps

Proteins are the essentials of tissue growth and regeneration, vital for wound healing and prevention. When consumed proteins are broken down, they produce amino acids, two of which are called arginine and glutamine, which provide energy for the necessary cells to do their job. Inadequate intake results in your body taking it from reserves in muscles and organs, thus delaying wound healing and recovery. It is best to get your protein source from both animal (e.g., fish, chicken, eggs, dairy, etc.) and vegetarian (e.g. soybeans, other legumes, nuts, seeds, oats, dark green leafy vegetables) sources.

Important Key Nutrients to Keep in Mind

A diabetic need plenty of vitamin A, D, E, K, B, C, potassium, phosphorus, zinc, selenium, iron to help maintain optimal wound healing. Best food sources for these are in most whole grains, beef liver, eggs, and some mushrooms.1 To increase the effective absorption of these nutrients, the body also needs healthy omega-3 and 6 fatty acids, also known as healthy fats. The best sources for these are ocean fish, avocado, nuts, and natural fat rich seeds like sunflower seeds. The collective effort of these nutrients stimulates collagen synthesis, reduce inflammation that restricts blood flow, thus facilitating the immune function for cell repair.4, 5

Wound prevention and healing for a diabetic heavily relies on their glycemic control. The best way for that is through low GI foods, slow-release carbohydrates, and high-quality proteins, plus some exercise. But how about for seniors and individuals who are unable to get enough protein? This is where oral nutritional supplements like Glucerna, No.1 Doctor Recommended Diabetes Nutritional Formula in the US~ is specifically designed for diabetes come into play. Backed by over 50 clinical trials over the years, Glucerna for diabetes has developed an exclusive Advanced Carbohydrates^ for better glycemic control. Also, with 4 times the myo-inositol^, the most effective carbohydrate to increase insulin sensitivity, Glucerna can help to improve blood glucose control within 3 months.# With up to 28 essential vitamins and minerals, like B, C, Omega 3, 6, 9 and high-quality protein, it provides a diabetic all around support for overall health. A healthy heart means it is able to keep blood flow efficient for oxygen and nutrient distribution, whilst reducing inflammation to keep immunity on track.

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References:

  1. https://ade.adea.com.au/nutrition-in-wound-healing-for-adults-with-diabetes-a-practice-update/#:~:text=A%20meal%20plan%20with%2040,thus%20vital%20for%20wound%20healing.
  2. https://www.apcofamerica.com/low-blood-flow-poor-circulation-diabetes/#:~:text=Diabetes%20can%20lead%20to%20poor,blood%20vessels%2C%20impeding%20your%20circulation.
  3. https://www.hmpgloballearningnetwork.com/site/twc/articles/diabetic-wound-healing-through-nutrition-and-glycemic-control
  4. https://onlinelibrary.wiley.com/doi/full/10.1111/dme.12509
  5. https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-019-0421-0
  6. https://abbottfamily.com.sg/products/page/glucerna-triple-care

Additional Readings:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349287/
  2. https://pubmed.ncbi.nlm.nih.gov/24053007/

^     Jenkins – 1982

#    Sun et al. Asia Pac J Clin Nutr. 2008.

~    IQVIA, using the ProVoice Survey, fielded to 14,853 physicians from January 1, 2020 to December 31, 2020.