Adults with diabetes and severe vitamin D deficiency are three times more likely to develop a diabetic foot ulcer than similar patients with sufficient vitamin D levels, according to findings from a meta-analysis published in Nutrition & Diabetes.
“Vitamin D has been suggested to play an important role in many chronic diseases, such as diabetes,” Yimin Chai, MD, PhD, professor in the department of orthopedic surgery at Shanghai Jiao Tong University, China, and colleagues wrote. “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.”
Chai and colleagues analyzed data from five retrospective cohort studies and two prospective cohort studies analyzing the relationship between serum vitamin D level and diabetic foot ulcer 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. Across studies, the researchers observed lower serum vitamin D levels in 543 patients with diabetic foot ulcer vs. 572 patients with diabetes but without diabetic foot ulcer (mean difference, –13.47 nmol/L; 95% CI, –16.84 to –10.1), with no between-study heterogeneity (P = .34). In sensitivity analyses, results were not influenced by any single study, according to researchers.
In four studies that reported on severe vitamin D deficiency, defined as a 25-hydroxyvitamin D level of less than 10 ng/mL, researchers observed severe deficiency in 216 patients with diabetic foot ulcer and in 108 patients with diabetes but without foot ulcer (48.98% vs. 22.78%), for an OR of 3.22 (95% CI, 2.42-4.28).
“The identification of the association of [diabetic foot ulcer] with vitamin D can give us some implications to develop new therapy for [diabetic foot ulcer],” the researchers wrote. “Vitamin D supplementation may be a valid therapeutic option for diabetes with foot ulcer and vitamin D deficiency.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.