A Rouland1, C Fourmont1, A L Sberna1,2, L S Aho Glele3, T Mouillot1, I Simoneau1, B Vergès1,2, J M Petit1,2, Benjamin Bouillet4,5. 1. Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France. 2. Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France. 3. Service d'épidémiologie et d'hygiène hospitalière, Hôpital François Mitterrand, CHU de Dijon, Dijon, France. 4. Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France. benjamin.bouillet@chu-dijon.fr. 5. Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France. benjamin.bouillet@chu-dijon.fr.
Abstract
AIM: Protein-energy malnutrition is known to be involved in wound healing. While wound healing in patients with diabetic foot ulcers (DFU) is a complex and multifactorial process, the role of malnutrition in this case has rarely been explored. The objective of this study was to determine whether the nutritional status of diabetic patients influences the healing of DFU. METHODS: 48 patients were included in this prospective, single-center study. All patients with comorbidities or factors involving malnutrition or influencing biological measurements were excluded. Patients were followed up for 24 weeks. RESULTS: The malnutrition rate was 29.2% at baseline and 25.6% at the end of the study. The difference was not significant. Of the 35 patients with wound healing, 29% were undernourished at inclusion and 17% at the end of the study. Of the 12 patients without wound healing, 50% were undernourished at inclusion, and 42% at the end of the study. These differences were not significant. Rate and speed of wound healing were not associated with malnutrition at inclusion. 15% of patients without malnutrition at baseline had final malnutrition. CONCLUSION: We demonstrated that wound healing was not affected by the initial presence of malnutrition. In our study, there is no evidence to support nutritional intervention to improve wound healing in diabetic patients. Nevertheless, malnutrition is responsible for an increase in morbidity and mortality and it is essential to identify malnutrition systematically for all patients with DFU, initially and during follow-up to treat it quickly and efficiently.
AIM: Protein-energy malnutrition is known to be involved in wound healing. While wound healing in patients with diabetic foot ulcers (DFU) is a complex and multifactorial process, the role of malnutrition in this case has rarely been explored. The objective of this study was to determine whether the nutritional status of diabeticpatients influences the healing of DFU. METHODS: 48 patients were included in this prospective, single-center study. All patients with comorbidities or factors involving malnutrition or influencing biological measurements were excluded. Patients were followed up for 24 weeks. RESULTS: The malnutrition rate was 29.2% at baseline and 25.6% at the end of the study. The difference was not significant. Of the 35 patients with wound healing, 29% were undernourished at inclusion and 17% at the end of the study. Of the 12 patients without wound healing, 50% were undernourished at inclusion, and 42% at the end of the study. These differences were not significant. Rate and speed of wound healing were not associated with malnutrition at inclusion. 15% of patients without malnutrition at baseline had final malnutrition. CONCLUSION: We demonstrated that wound healing was not affected by the initial presence of malnutrition. In our study, there is no evidence to support nutritional intervention to improve wound healing in diabeticpatients. Nevertheless, malnutrition is responsible for an increase in morbidity and mortality and it is essential to identify malnutrition systematically for all patients with DFU, initially and during follow-up to treat it quickly and efficiently.
Entities:
Keywords:
Diabetic foot ulcer; Healing; Malnutrition; Type 2 diabetes
Authors: Cristian Loretelli; Moufida Ben Nasr; Giorgio Giatsidis; Roberto Bassi; Luca Lancerotto; Francesca D'Addio; Alessandro Valderrama-Vasquez; Saja Sandra Scherer; Luca Salvatore; Marta Madaghiele; Ahmed Abdelsalam; Elio Ippolito; Emma Assi; Vera Usuelli; Basset El Essawy; Alessandro Sannino; Giorgio Pietramaggiori; Gian Vincenzo Zuccotti; Dennis Paul Orgill; Paolo Fiorina Journal: Acta Diabetol Date: 2020-03-02 Impact factor: 4.280