The first principle is to identify the underlying functional, physiological, or pathological cause of the malnourished state. If the condition is curable, then the management issues are simplified. For instance, if a person is dehydrated because of hyperglycemic diuresis in uncontrolled diabetes mellitus, the short-term management involves administration of exogenous intravenous fluids to restore normal hydration; however, restoring adequate diabetic control to the patient would be the long-term and definitive solution. The undernutrition and growth failure due to undetected celiac disease is easily eliminated by institution of a gluten-free diet. With deficient nutrition in cystic fibrosis, adequate management of pulmonary problems and digestive-enzyme should allow patients to recover and maintain normal nutrition on a balanced oral diet. Thus, medical or surgical address of the underlying disorder, where possible, is the primary tool for management of secondary undernutrition.
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