NUTRITIONAL SUPPORT FOR MANAGING DIABETIC CHRONIC LEG ULCERS IN SOUTH INDIA - A CASE REPORT

Malnutrition and poor glycemic control are well-established risk factors for delayed wound healing especially in diabetic foot ulcer (DFU). Diabetes is a growing public health concern in India, with poor awareness, treatment, and glycemic control contributing to complications. Hence, it is important to provide nutrition support through nutrition care process (NCP). This case report examines the impact of personalized nutrition intervention in managing DFU using the NCP. A 62-year-old male with Type 2 Diabetes Mellitus and a pre-patellar chronic leg ulcer underwent nutritional screening using the malnutrition universal screening tool (MUST) and a modified tool. A tailored NCP was implemented, emphasizing high-protein, fiber-rich, and low-glycemic foods, along with micronutrient support and oral supplementation. Nutritional interventions improved metabolic control and wound healing. Rice was replaced by millets to provide a low-glycemic, fiber-rich carbohydrate source. The diet was adjusted to include more vegetables and fresh vegetable salads to improve vitamin and mineral intake, supporting immune function and inflammation reduction. For high-quality vegetarian protein, meal maker (soy chunks) and cottage cheese (paneer) were incorporated into meals. The patient was also encouraged to consume curd and buttermilk with meals to promote gut health and digestion. To ensure adequate protein and energy intake, commercial oral nutritional supplement (ONS) and malted porridges as ONS was provided during mid-morning and bed-time. Additionally, fruit intake was increased to twice a day, supplying essential antioxidants, fiber, and vitamins necessary for wound healing and metabolic balance. Vitamins A and C supported tissue repair, while fenugreek supplementation aided glycemic control. Post-surgical progressive feeding and personalized counseling enhanced adherence and recovery. Regular monitoring ensured timely dietary adjustments. This case highlights the role of structured nutritional care in DFU management. Early screening and targeted dietary strategies promote healing, prevent complications, and improve glycemic control. Future studies should explore long-term outcomes and standardized nutrition protocols for diabetes care.