Vitamin D Status in a Bulgarian Population With Type 2 Diabetes and Diabetic Foot Ulcers

2020 ◽  
pp. 153473462096582
Author(s):  
Ani S. Todorova ◽  
Edward B. Jude ◽  
Rumyana B. Dimova ◽  
Nevena Y. Chakarova ◽  
Mina S. Serdarova ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Diabetic Peripheral Neuropathy ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Active Infection

The aim of this study was to assess vitamin D status in patients with type 2 diabetes and diabetic foot ulcers (DFU). A total of 242 participants with type 2 diabetes, mean age 59.1 ± 10 years, mean body mass index 31.4 ± 6.3 kg/m2, and estimated glomerular filtration rate ≥45 mL/min/1.73m2, were divided into 2 groups: 73 with DFU (35 with and 38 without active infection) and 169 without DFU (106 with diabetic peripheral neuropathy, 63 without complications). Neuropathy was assessed by 10 g monofilament, Rydel-Seiffer 128 Hz tuning fork, and temperature discrimination. Serum 25(OH)D (25-hydroxy vitamin D) was assessed by ECLIA (electro-chemiluminescence immunoassay) method. Median 25(OH)D level was 12.6 ng/mL (IQR [interquartile range] 9.3-17.6 ng/mL) in the studied cohort. The DFU group presented with lower 25(OH)D level as compared with diabetic patients without foot ulcers (non-DFU group): 11.6 ng/mL (IQR 8.5-15.8 ng/mL) versus 13.5 ng/mL (IQR 9.6-18.6 ng/mL), P = .001; the diabetic peripheral neuropathy subgroup demonstrated lower 25(OH)D level in comparison with participants without complications: 12.5 ng/mL (IQR 9-17.2 ng/mL) versus 15.9 ng/mL (IQR 10.4-20.8 ng/mL), P = .031. This remained significantly different even after correction for age and duration of diabetes. There was no difference in 25(OH)D level between the subgroups according to the presence of active infection. In conclusion, vitamin D deficiency may play a role in the development of diabetes complications.

588-P: Vitamin D Status in a Bulgarian Population with Type 2 Diabetes and Diabetic Foot Ulcers

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 588-P
Author(s):  
ANI S. TODOROVA ◽  
RUMYANA DIMOVA ◽  
NEVENA CHAKAROVA ◽  
MINA SERDAROVA ◽  
GRETA GROZEVA-DAMYANOVA ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Bulgarian Population

scholarly journals The Effect of Shear Force on Skin Viability in Patients with Type 2 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Luuk A. de Wert ◽  
Margot Geerts ◽  
Sander van der Brug ◽  
Laura Adriaansen ◽  
Martijn Poeze ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Foot ◽  
Shear Loading ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Type 2 Dm ◽  
Hyperaemic Response ◽  
Skin Responses ◽  
Healthy Participants

Background. Shear is a major risk factor in the development of diabetic foot ulcers, but its effect on the skin of patients with type 2 diabetes mellitus (DM) remains to be elucidated. The aim was to determine skin responses to shear in DM patients with and without diabetic polyneuropathy (DNP). Methods. The forearm skin was loaded with 14.5 N shear (+2.4 kPa pressure) and with 3.5 kPa pressure for 30 minutes in 10 type 2 DM patients without DNP, 10 type 2 DM patients with DNP, and 10 healthy participants. A Sebutape collected IL-1α (measure of tissue damage). A laser Doppler flowmeter measured cutaneous blood cell flux (CBF) as a measure of the reactive hyperaemic skin response. Findings. Reactive hyperaemia and IL-1α release was significantly increased after shear loading in all three groups and was higher compared to the responses to pressure loading. The reactive hyperaemic response after shear loading was impaired in patients with type 2 DM compared to healthy participants but did not differ between patients with and without DNP. The reactive hyperaemic response was negatively correlated with the blood glucose level but did not correlate with the DNP severity score. Interpretation. Shear is important in the development of tissue damage, but the reparative responses to shear are impaired in patients with type 2 DM. DNP was not associated with altered skin responses, suggesting that the loss of protective sensation to sense shear to skin remains a key factor in the development of diabetic foot ulcers in patients with DNP.

scholarly journals Diabetic Foot Ulcers and Risk Fall in People with Type 2 Diabetes Mellitus in BLUD RSUD Dr. Ben Mboi Manggarai Regency, NTT

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Oliva Suyen Ningsih ◽  
Kornelia Romana Iwa ◽  
Maria Getrida Simon ◽  
Kataria Anastasia Sinar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Foot Ulcers ◽  
Risk Of Falling ◽  
Risk Of Falls

The prevalence of diabetes mellitus in Manggarai Regency in 2019 is 535 people and some of them have diabetic foot ulcers. Patients with diabetic foot ulcers had a higher risk of falling than others.This study was to determine the risk factors for diabetic foot ulcers and the risk of falls in patients with type 2 diabetes mellitus. A quantitative study using a cross-sectional study was conducted at BLUD RSUD dr. Ben Mboi  in April-June 2020 (n = 51).The sampling technique used was purposive sampling with a questionnaire of diabetic foot screening and risk stratification form and Morse scale. Logistic regression results showed that there was a significant relationship between claudication (AOR: 8.409, 95% CI 1.664-42.500, p value 0.010), history of previous diabetic foot ulcers (AOR: 5,680, 95% CI 1,151-28,035, p value 0.033) with diabetic foot ulcers. There was a significant relationship between hypertension (AOR: 0.152, 95% CI 0.028-0.834, p value 0.030), diabetic foot ulcers (AOR: 11.392, 95% CI 1.277-101.651, p value 0.029) with the risk of falling for patients with type 2 diabetes mellitus.  Assessment of the risk of diabetic foot ulcers and the risk of falls should be done in patients with diabetes mellitus with or without neuropathy peripheral

scholarly journals Effect of Exercise Volume on Plantar Microcirculation and Tissue Hardness in People With Type 2 Diabetes

2021 ◽  
Vol 9 ◽  
Author(s):  
Weiyan Ren ◽  
Yijie Duan ◽  
Yih-Kuen Jan ◽  
Wenqiang Ye ◽  
Jianchao Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Energy Expenditure ◽  
Diabetic Foot ◽  
Weight Bearing ◽  
Physical Activities ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Tissue Hardness ◽  
Volume Group

Objective: Exercise has been reported to be beneficial for people with type 2 diabetes (T2DM), but exercise, especially weight-bearing exercise, may increase the risk of diabetic foot ulcers (DFUs). This study aimed to explore the associations between different volumes of weight-bearing physical activities and plantar microcirculation and tissue hardness in people with T2DM.Methods: 130 elderly people with T2DM were enrolled for this cross-sectional study. They were classified into the high exercise volume group and the low exercise volume group based on their weekly energy expenditure (metabolic equivalents per week) in the past year. Weekly energy expenditure was calculated using the International Physical Activity Questionnaire and the Compendium of Physical Activities. The plantar oxygen saturation (SO2) and soft tissue hardness of each participant’s right foot were measured.Results: A total of 80 participants completed the trial. The average exercise energy expenditure of the high exercise volume group and the low exercise volume group were significantly different (p < 0.05). The results showed that the SO2 of the high exercise volume group (67.25 ± 6.12%) was significantly higher than the low exercise volume group (63.75 ± 8.02%, p < 0.05). The plantar tissue hardness of the high exercise volume group was lower than the low exercise volume group in the big toe, midfoot and hindfoot regions (p < 0.05).Conclusion: This study demonstrates that higher volumes of exercise are associated with better plantar microcirculation and lower plantar tissue hardness in people with T2DM. The findings of this study indicate that weight-bearing exercise may not increase risk of developing diabetic foot ulcers.

565-P: Serum 25-Hydroxy Vitamin D Levels in Relation to Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 565-P
Author(s):  
LEI ZHANG ◽  
YAN GU ◽  
YUXIU YANG ◽  
YAMEI ZHU ◽  
XIAOYAN YIN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

scholarly journals Diabetic Foot Ulcers and Vitamin D Status: A Literature Review

2018 ◽  
Vol 4 ◽  
pp. 237796081878902 ◽  
Author(s):  
Antony Macido
Keyword(s):  
Vitamin D ◽  
Diabetic Foot ◽  
Large Scale ◽  
Negative Relationship ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Diabetic Foot Infections ◽  
Randomized Controlled Studies

Approximately 15% of patients with diabetes mellitus (DM) are prone to developing diabetic foot ulcers (DFU) in their lifetime. The term vitamin D status or 25-hydroxyvitamin D (25(OH)D) levels is used interchangeably to represent the status of vitamin D in individuals throughout this article. Evidence suggests a relationship between 25(OH)D levels and DFU. However, very minimal data are available on the association between DFU and vitamin D deficiency. After a careful review of the literature, it was inferred that vitamin D could be associated with DFU and diabetic foot infections. Available evidence on vitamin D and DFU suggests a negative correlation between 25(OH)D levels and the presence of DFU. Evidence also supports a negative relationship between 25(OH)D levels and diabetic foot infections. Further large-scale randomized controlled studies need to be done to confirm the relationship between 25(OH)D levels and DFU including the use of vitamin D in the management of DFU and diabetic foot infections.

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