Objective

Overview

Screening and Assessment

Nutrition and Healing

Nutritional Support

Common Questions

Helpful Websites for Recipes and Nutrition Information

Design and created by Guideline Central in participation with the American Limb Preservation Society and Consensus and Physician Experts.

Nutrition Interventions in Adults with Diabetic Foot Ulcers

Consensus and Physician Experts

American Limb Preservation Society

Publication Date: May 1, 2025

Zinc:
- Men need 11 milligrams per day; women need 8 milligrams per day.
- Do not take more than 40 milligrams per day.
- Zinc is found in meat, fish, eggs and foods with good-quality protein.
- Zinc is a mineral needed for cell growth and making new cells.
- A healthcare provider should monitor zinc levels to keep them in a healthy range.
Vitamin C:
- Men need 90 milligrams per day; women need 75 milligrams per day.
- Do not take more than 2000 milligrams per day.
  - Taking too much Vitamin C over a long time might cause mineral deposits in bones or soft tissues.
- Smokers need an extra 35 milligrams per day.
- Vitamin C is found in citrus fruits and juices (like oranges), tomatoes, potatoes and broccoli.
- Vitamin C is very important for repairing body tissues. It:
  - Helps the body make scar tissue (collagen)
  - Supports immune cells in healing wounds
  - Strengthens wounds
  - Helps the body absorb iron
  - Helps copper be useful
  - Helps with protein use.
- High doses are sometimes used to protect cells from damage (antioxidants).
Vitamin D:
- For people under 70 years old, 600 international units per day (15 micrograms) are needed. For over 70 years old, 800 international units per day (20 micrograms) are needed.
- Do not take more than 4000 international units per day.
- Vitamin D is found in fish liver oils, fatty fish, milk with added vitamin D and fortified breakfast cereals.
- Sunlight exposure allows the skin to produce vitamin D.
- Vitamin D helps the body absorb calcium from food and keeps calcium and phosphate levels in the blood healthy for strong bones.
- Vitamin D also helps reduce inflammation, controls cell growth, and supports muscle, nerve, immune functions, and blood sugar control.
Vitamin E:
- 15 milligrams are needed per day.
- Do not take more than 1000 milligrams per day.
- Vitamin E levels in the blood depend on how well the liver is working.
- Vitamin E is found in wheat germ, seeds, nuts, vegetable oils, green leafy vegetables and fortified breakfast cereals.
- Vitamin E is a fat-soluble, antioxidant vitamin that protects cells from damage and helps keep cell membranes healthy.
- It helps with normal fat use and making scar tissue (collagen).
- Studies have shown that Vitamin E, when combined with arginine and zinc in high-calorie oral supplements, helps heal pressure injuries like bed sores.
Vitamin B12:
- Ages 14+ need 2.4 micrograms per day.
- It is unlikely that high amounts of daily intake will cause adverse health effects.
- Vitamin B12 levels can be checked with a blood test.
  - Levels below 200 or 250 picograms per milliliter are considered low.
- Vitamin B12 is found in foods from animals, like fish, meat, chicken, eggs and dairy products. It’s also found in fortified breakfast cereals nutritional yeast.
Vitamin A:
- Men need 900 micrograms per day; women need 700 micrograms per day.
- Do not take more than 3000 micrograms per day.
- Vitamin A is found in beef liver, fish oils, fish, milk, eggs and fortified cereals.
  - Provitamin A (which the body turns into Vitamin A) is found in orange and yellow vegetables (like carrots and squash), tomato products and broccoli.
- Vitamin A supports wound strength and the growth of healthy new tissue.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Nutrition Interventions in Adults with Diabetic Foot Ulcers

Objective

Overview

Definitions

Screening and Assessment

Importance of Early Detection

Physical Examination

Patient History

Other Health Conditions

Risk Factors

Lab Tests

Nutrition and Healing

Factors Crucial for Healing

Hydration

Calories

Macronutrients

Protein

Protein Needs

Carbohydrates and Fats

Carbohydrate Management

Fats

Blood Sugar Goals in the Hospital

Tips for Managing Blood Sugar Through Diet

Hydroxymethylbutyrate: A Muscle-Supporting Nutrient

Arginine: A Healing Amino Acid

Glutamine: Helping the Body During Healing

Micronutrients

Key Vitamins and Minerals for Healing

Nutritional Support

Oral Nutrition Supplements (ONS)

Using Oral Nutrition Supplements

When Eating or Supplements Aren't Enough

Special Populations

Common Questions

Helpful Websites for Recipes and Nutrition Information

Disclaimer