Vitamin D: Another Important Nutritional Metric in DFU

A recent meta-analysis in the International Wound Journal took a closer look at vitamin D deficiency and patients with diabetic foot ulcers (DFUs). Lin and colleagues’ literature search initially included over 7,500 subjects with diabetes.1 They found that those subjects with diabetic foot ulcers had significantly lower levels of vitamin D, higher prevalence of vitamin D deficiency (less than 50 nmoL/L) and more severe vitamin D deficiency than those without DFU.

Given the emergence of more and more data that Vitamin D is a key factor in many types of healing, I think getting vitamin D levels will become more and more commonplace in our interdisciplinary clinics. We work closely with our registered dietitians (RDs) and they are simply invaluable partners in our overall treatment team. Certainly, vitamin D levels should be part of the overall consideration when looking at the impact of nutrition on DFU, like we do with albumin, pre-albumin, total protein, and other metrics.

I strongly believe that we need to be focusing on this all-too-often neglected part of care. We feel that it is "squishy" because there haven't been a lot of data to support it in the past and it has seemed (because of the limited amount we have gotten during our training) to something "other." I think that is changing - for the better. It's for the better of our patients and our communities!

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2022/05/15/association-between-vitamin-d-deficiency-and-diabetic-foot-ulcer-wound-in-diabetic-subjects-a-meta%e2%80%90analysis-alpslimb-nutrition-actagainstamputation/ . It is adapted with permission from the author.

Reference

1. Lin J, Mo X, Yang Y, Tang C, Chen J. Association between vitamin D deficiency and diabetic foot ulcer wound in diabetic subjects: a meta-analysis. Int Wound J. 2022. Online ahead of print. doi: 10.1111/iwj.13836.