Effects of Nutrition Intervention on Blood Glucose, Body Composition, and Phase Angle in Obese and Overweight Patients with Diabetic Foot Ulcers

Abstract

Nutrition can play an important role in the treatment of chronic wounds such as diabetic foot ulcers (DFUs); however, diet therapy is not currently part of the standard care for DFUs. There are numerous controversies about dietary recommendations, especially regarding calories and macronutrients, for overweight and obese patients with DFUs. This study examined the effects of nutrition education and supplementation on body composition in overweight and obese patients with DFUs. Twenty-nine patients with DFUs between the ages of 30 and 70 years were randomly assigned to either the treatment group (nutritional supplements, diet education, and standard care) or the control group (standard care). At baseline, the mean body mass index (BMI) was 33.5 kg/m2 for the treatment group and 34.1 kg/m2 for the control group. HbA1c decreased in both groups, with no significant difference between the groups. On average, patients in the treatment group lost less lean body mass and gained less fat than the control group ((3.8 kg vs. 4.9 kg) and (0.9 kg vs. 3.6 kg), respectively). While the interaction between group and time did not reach statistical significance for any of the study variables after adjustments for confounding variables, the observed changes are clinically relevant.

Effects of continuing nursing intervention on high‐risk patients with diabetic foot ulcers: A meta‐analysis

“…Glycaemic control is closely associated with DF incidence and prognosis, with effective control being pivotal in treatment 41 . Fasting and 2‐h postprandial blood glucose, along with glycated haemoglobin, are reliable indicators of glycemic control in DM 42,43 .…”

The Comparison of Nutritional Supplementation on Wound Healing in Type 2 Diabetes Patients with Foot Ulcers: A Systematic Review

“…Basiri and colleagues compared several different protein quantities containing L-arginine paired with different vitamins, minerals, and glucose control supplementation combinations to examine a difference in the rate of wound healing. (16), ( 17), (18) The earlier random control trial from the Basiri et al researchers' group had an intervention of two servings of a nutrient-dense formula containing 500 kcal, 28 g of protein with L-arginine present, with several flavor options available, and Boost Glucose Control for 12 weeks. (16) The energy at baseline for the intervention group was 53.2% and the control was 42.7%.…”

“…(16), ( 17), (18) The earlier random control trial from the Basiri et al researchers' group had an intervention of two servings of a nutrient-dense formula containing 500 kcal, 28 g of protein with L-arginine present, with several flavor options available, and Boost Glucose Control for 12 weeks. (16) The energy at baseline for the intervention group was 53.2% and the control was 42.7%. (16) A t12 weeks the intervention group significantly increased (p= 0.03) to 70.5% for the intervention group.…”

Assistência tópica e a importância da nutrição no processo de cicatrização de feridas em pacientes diabéticos

“…A intervenção também diminuiu significativamente a inflamação no grupo de tratamento, relatou que a ocorreu uma redução da inflamação de baixo grau (menor Interleucina IL6maior mediador da resposta inflamatória e IL1βmediador leucocitário) diminuiu a perda de massa muscular e elevou a síntese de proteína muscular em 24,8% ( p < 0,05). Assim sendo, a melhor preservação da massa corporal magra que ocorreu no grupo de tratamento pode ter ocorrido em parte como resultado da diminuição da inflamação no grupo de tratamento, devido ao aumento da ingestão de micronutrientes e antioxidantes (Basiri et al, 2022).…”

“…E quando a ferida estiver totalmente cicatrizada, restrições calóricas com suporte nutricional devem ser aplicadas se necessário. Identificar a ingestão dietética adequada de macro e micronutrientes em pacientes diabéticos com pé ulcerado, em especial para aqueles com sobrepeso ou obesidade, é fundamental para acelerar o processo de cicatrização de feridas e pode fazer uma diferença substancial nas despesas médicas e na qualidade de vida neste população (Basiri et al, 2022).…”