Vitamin D deficiency linked to three fold rise of foot ulcers in diabetes

Diabetics with severe vitamin D deficiency are three times more likely to develop a diabetic foot ulcer, finds a new study.

"Vitamin D has been suggested to play an important role in many chronic diseases, such as diabetes," write the authors. "Low serum vitamin D levels are associated with insulin resistance, impaired beta-cell function and the development of [diabetes]. There is also ongoing interest in the association between lower level of vitamin D and diabetic complications."

Diabetic foot ulcer (DFU) is a serious complication in diabetes patients which may even lead to amputation if not treated properly and on time. Studies have reported that patients with DFU have higher mortality compared with nonulcerated diabetic patients. However, the study exploring contributory factors on DFU are lacking.

In recent years, there is an increasing interest in the beneficial role of vitamin D in diabetes mellitus (DM). Adding more to the growing body of literature, a new study in the journal Nutrition & Diabetes has found that diabetes patients with vitamin D deficiency are at significantly higher risk of developing a diabetic foot ulcer (DFL) compared to diabetic patients with sufficient vitamin D.

"This is the first meta-analysis demonstrating the association between serum vitamin D levels and DFU," the authors write.

Yimin Chai, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, and colleagues evaluate the association between vitamin D deficiency and DFU in patients with diabetes in this meta-analysis.

The researchers analyzed data from five retrospective cohort studies and two prospective cohort studies in 1,115 patients with a mean age ranging from 50 to 70 years. Researchers assessed mean vitamin D levels in patients with and without diabetic foot ulcer.

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Key findings of the study include:

• Seven studies reported significantly lower serum vitamin D levels in 543 patients with DFU than in the 572 DM group.


• Four studies reported data on severe vitamin D deficiency. Severe vitamin D deficiency was reported in 216 (48.98%) patients with DFU and 108 (22.78%) in the DM group.


• Severe vitamin D deficiency (25-OHD < 10 ng/mL) was significantly associated with the risk of DFU.

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Identification of the association between diabetic foot ulcer and vitamin D can give some implications for the development of a new therapy for D," wrote the authors. "Vitamin D supplementation may be a valid therapeutic option for diabetes with foot ulcer and vitamin D deficiency."

"Severe vitamin D deficiency is significantly associated with an increased risk of DFU. More specifically designed studies are needed in the future," they concluded.

For detailed study follow the link: https://doi.org/10.1038/s41387-019-0078-9