Author(s): Saino Y, Wakabayashi H, Maeda K, Nishioka S, Hao T, Mimatsu K
BACKGROUND AND OBJECTIVES: Severe infection, inadequate food intake, and pressure ulcers in patients with type 2 diabetes can result in malnutrition. We describe a case in which rehabilitation nutrition was effective for treat-ing a pressure ulcer in a malnourished patient with type 2 diabetes.
METHODS AND RESULTS: A 58-year-old man with type 2 diabetes was diagnosed with hidradenitis suppurativa on the left buttock and thigh and a severe pres-sure ulcer on his left kneecap. Malnutrition was related to hypermetabolism caused by chronic hidradenitis suppu-rativa and inadequate protein-energy intake before admission. We initiated a rehabilitation nutrition intervention to improve physical function and to treat a pressure ulcer by prescribing 2,000 kcal/day of food, including 80 g of protein, and physical rehabilitation for 40 minutes/day. The patient showed good progress in terms of his physical function and healing of the pressure ulcer. After prescribing 2,250 kcal/day of food, including 85 g of protein, and physical rehabilitation for 60 minutes/day, HbA1c levels increased to 7.4%. The energy prescription was de-creased to 2,000 kcal/day to improve glycemic levels. Then, the patient’s weight decreased and his hand grip strength became weaker. On day 134 and discharge the patient could walk independently with a t-cane and ankle supporter. By day 14 after discharge, the pressure ulcer had epithelialized.
CONCLUSION: Rehabilitation nutrition management improved physical function and facilitated pressure ulcer healing in a malnourished patient with type 2 diabetes. Close conjoint management of hyperglycemia was also necessary.
Dermatology Journal and/or Publisher
Journal Name: Asia Pacific journal of clinical nutrition
Journal Abbreviation: Asia Pac J Clin Nutr
Journal Date Published:
National Center for Biotechnology Information
Article Source: http://www.ncbi.nlm.nih.gov/pubmed/29737823
Lasted Revision: 2018-05-08
Abstract Source: National Center for Biotechnology Information, U.S. National Library of Medicine Abstract Query for Hidradenitis suppurativa (HS).
Tags: Diabetes Diet Nutrition Ulcerative Colitis