Abstract

According to the study entitled “Turkey Diabetes, Hypertension, Obesity and Endocrinology Diseases Prevalence Study-II” that was conducted in Turkey, the prevalence of diabetes was 13.7%. An important complication that concerns most medical disciplines involved in the treatment of diabetes patients group is the development of diabetic foot ulcers. The most important risk factors for the development of this complication are neuropathy, overpressure-induced foot deformity, external trauma, infection, and peripheral arterial disease. In the treatment of diabetic foot ulcers, the ideal treatment goals are effective removal of the necrotic tissues with sharp dissection, if possible; dressing to facilitate the absorption of the exudate and healing of the ulcer area; and selection of appropriate shoes or materials to reduce the pressure on the ulcer floor. If necessary, vacuum wound dressings, hyperbaric oxygen therapy, and granulocyte stimulating factor may be used. Moreover, bypass surgery or angioplasty methods can be used in patients with low peripheral blood flow to reduce the rate of ischemia. In the presence of clinical findings that indicated infection, tissue sampling should be performed from the ulcer tissue, and antibiotic treatment should be given as per the results of the culture antibiogram. Delay in treatment can lead to the progression of infectious agents into deep tissues and undesirable orthopedic interventions. After amputation, the disease starts affecting the social life of the patient. The required long-term physical therapy and rehabilitation program should be planned in consideration of the considerable psychological disruption caused by the condition and treatment. The healthcare cost associated with this disorder also poses a problem. Two important points that need to be remembered during this process, and are easy to control are good glycemic control and healthy food intake. Good glycemic control and effective nutritional support can sometimes heal the ulcer and make treatment possible. In this regard, it is important to understand the value of nutritional supplements that replace glutamine and arginine, which are normally present in sufficient amount in our body but become essential in catabolic processes.

Keywords: Arginine, diabetic foot ulcer, enteral nutrition, glutamine