Vitamin D supplementation and diabetic foot ulcers

NewsBot · Jan 8, 2024

Vitamin D supplementation improves foot ulcers among diabetic patients: Pooled analysis of randomized controlled trials
Muhammad IA. Putra et al
Source

Serum vitamin D level is associated with the development of diabetic foot ulcer (DFU), and it is intriguing to determine if the vitamin supplementation could reverse the diabetic complication. The aim of this study was to investigate the efficacy of vitamin D supplementation in DFU management through qualitative and quantitative systematic review. A systematic search was conducted to screen the records identified in PubMed, Scopus, Embase, Scillit, Sci-Finder, LILACS, EuropePMC, medRxiv, bioRvix, Google Scholar, Semantic Scholar, and Garuda databases as of 10 March 2023. Studies investigating the efficacy of a single dose supplementation of vitamin D in DFU management were included. Quality of the included studies was appraised by Cochrane ‘Risk of Bias’ 2.0. Random-effects-based pooled analysis using Cohen’s d was performed on the wound healing progress as the primary outcome. A sensitivity test with leave-one-out method and meta-regression were also conducted to analyze the effect of heterogenous data. Five studies with a total of 245 patients (123 versus 122 for experimental and control groups, respectively) were finally included in the qualitative and quantitative analysis. The pooled estimate suggested that administering vitamin D to DFU patients could reduce the wound area or depth significantly as compared to control group (p<0.001; Cohen’s d: 2.72; 95% CI: 1.02 to 4.42). The value remained positive throughout the leave-one-out analysis. Vitamin D supplementation significantly contributed to the increased level of serum vitamin D (p=0.026, Cohen’s d: -0.719; 95% CI: -1.35 to -0.09). Elevation of high-density lipoprotein was observed in pooled estimate with p=0.016 and Cohen’d: 1.34 (95% CI: 0.25 to 2.44). Qualitatively, significant reduction of HbA1C, total cholesterol, and C-reactive protein were reported in at least two trials. Significantly improved quantitative insulin sensitivity check index (QUICKI) and decreased malondialdehyde, fructosamine, and fasting blood glucose were reported in at least one trial each. There were conflicting results on the change of low-density lipoprotein level. This study highlights that vitamin D supplementation promotes wound healing process among DFU patients; however, it is too premature to draw solid conclusions as the efficacy could be affected by multiple factors. Therefore, clinical trials from various demographics and ethnicities by using a high- versus low-dose model are needed.
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NewsBot · Jan 8, 2024

Role of polymorphism in vitamin D receptor gene on diabetic foot ulcer: A systematic review and meta-analysis
Saminan Saminan et al
Journal of Pharmacy & Pharmacognosy Research, 12 (2), 348-362, 2024

Context: Once vitamin D is converted to its active form, the molecule binds to its receptor (VDR) and performs its function as a transcription factor in modulating immune response, inflammation cascade, and insulin signaling. Among diabetic individuals, these activities are thought to be correlated with foot ulceration. Gene polymorphisms could change the function of VDR, thereby affecting the development of foot ulceration among individuals with diabetes. Aims: To construct evidence on the role of VDR gene variants or single nucleotide polymorphisms (SNPs) on diabetic foot ulcers. Methods: Records reporting the distribution of genotypes and/or alleles among diabetic foot ulcer (DFU) patients and published until 10 March 2023 were retrieved from 12 major databases using predetermined keywords. The original research articles included in the study were assessed for reporting quality using the Newcastle Ottawa Scale. The quality of genotypic and allelic data was appraised by Hardy-Weinberg equilibrium (HWE). A quantitative analysisbased fixed-effects model was performed to estimate the proportion of genotype and allele frequencies among DFU patients. Results: Three studies were included in the systematic review reporting the FokI (rs2228570), TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232) SNPs. Based on pooled estimates, among DFU patients CC, CT, and TT genotypes of VDR FokI SNPs had a prevalence of 45%, 43%, and 12%, respectively, without significant heterogeneity found in the reported data (p-Het<0.001; I2>0%). ApaI and FokI were associated with DFU, while no association in all genotypic and allelic models was found between TaqI or BsmI and DFU. CC genotype of BsmI and T allele of FokI was associated with oxidative stress (one of the underlying factors in DFU). Conclusions: Certain genotypes and alleles of FokI and ApaI SNPs could act as the risk factor for foot ulceration among diabetic individuals. More high-quality studies are still needed to draw solid conclusions on the role of VDR SNPs among DFU patients.
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NewsBot · Jan 17, 2024

Analysis of the association between serum levels of 25(OH)D, retinol binding protein, and Cyclooxygenase-2 and the disease severity in patients with diabetic foot ulcers
Xuehui Chen, Yun Xu, Xiangyu Meng, Ruina Geng, Xu Wang, Guanying Zhang, Liwei Bai
16 November 2023

Diabetic foot ulcers (DFUs) pose significant clinical challenges, representing severe complications in diabetes mellitus patients and contributing to non-traumatic amputations. Identifying reliable biomarkers can optimize early diagnosis and improve therapeutic outcomes. This study focused on evaluating the association between serum levels of 25-hydroxyvitamin D [25-(OH)D], Serum Retinol Binding Protein (RBP), and Cyclooxygenase-2 (COX-2) in elderly DFU patients. A retrospective study involving 240 participants, from March 2020 to March 2023. The participants were segmented into three cohorts: 80 with DFUs, 80 diabetic patients without DFUs, and 80 healthy controls. Serum concentrations of the three biomarkers were assayed using methods like enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay, and an automated biochemistry analyser. Comparisons were made both between groups and within the DFU group based on disease severity. Statistical analysis revealed significant differences in biomarker levels across the groups (p < 0.05). COX-2 and RBP concentrations were highest in the DFU group, followed by the non-DFU diabetic group, and lowest in the control group. Conversely, 25(OH)D levels were highest in the control group, followed by the non-DFU diabetic group, and lowest in the DFU group. Within the DFU group, RBP and COX-2 levels increased with disease severity, while 25(OH)D levels decreased. These variations were especially pronounced in patients with the most severe Wagner grading. A significant positive correlation was observed between disease severity and levels of RBP (r = 0.651, p < 0.05) and COX-2 (r = 0.356, p < 0.05). Conversely, a significant negative correlation was identified between disease severity and 25(OH)D levels (r = −0.658, p < 0.05). Assessing 25(OH)D, RBP, and COX-2 serum levels offers a promising tool for evaluating the severity and progression of DFUs. Monitoring these biomarkers can enrich our understanding of the metabolic and inflammatory pathways of the disease and potentially refine therapeutic strategies.
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NewsBot · Feb 29, 2024

Literature Review: Role of Vitamin D in Diabetic Foot Ulcer Wound Healing.
Dahlan, K. ., Irfanuddin, Murti, K. ., & Muradi, A. . (2023).
Jurnal Penelitian Pendidikan IPA, 9(10), 854–867.

DFU is a common consequence of DM. Vitamin D has multiple positive effects on DFU. Search data from; Google Scholar, Science Direct, Elsevier, EBSCO, Medline and PubMed. Publication at least ten years (2013 until 2022). Inclusion criteria; full paper in English, Study about vitamin D and DFU in human, exclusion criteria; animal model and invitro study. Results; 27 journals; Seven Randomized Controlled Trial. Vitamin D phase on DFU which one substantially smaller. Severe vitamin D insufficiency known with significance linked for an elevated risk of DFU. Vitamin D supplementation can prevent or improve diabetic foot complications
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Vitamin D supplementation and diabetic foot ulcers

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Vitamin D supplementation and diabetic foot ulcers

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Growing pains and vitamin D supplementation

Calcaneal spur and vitamin D, lipid profile and calcitonin

Vitamin C to prevent CRPS after foot surgery

Vitamin D and verrucae

Westmead study shows vitamin C prevents ulcer-related amputations

Vitamin B12 Deficiency and Foot Ulcers in Type 2 Diabetes Mellitus

Intralesional Vitamin D Injection for Verruca

Share This Page

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