Micronutrient status of patients with diabetic foot: A systematic review.

Abstract

Background and objectives: Micronutrient status encompasses a range of indicators that reflect the levels and balance of macro- and microelements, as well as vitamins within the body. These essential substances, required in minimal amounts, are crucial for supporting normal physiological processes, immune system functioning, and tissue repair. The aim of this systematic review is to summarize data on the deficiency or excess of microelements, macroelements, and vitamins in patients with diabetic foot ulcers.

Methods and study design: Databases were searched for studies on vitamin, macronutrient, micronutrient levels and their impact on the course, treatment and healing of diabetic foot ulcers. The Cochrane Risk of Bias tool was employed for assessing randomized trials, while the Newcastle-Ottawa Scale was utilized for evaluating observa-tional studies in terms of quality and bias risk.

Results: The findings revealed a notable correlation between deficiencies in vitamins D, C, A and the severity of clinical symptoms. Low vitamin D levels were linked to elevated proinflammatory cytokines. Higher concentrations of folate and vitamin B-12 were associated with improved ulcer healing, supplementation with zinc and magnesium contributed to a reduction in ulcer size. Inadequate intake of zinc, vitamins E, C was found to compromise antioxidant defences. Elevated ferritin levels may serve as an indicator of inflammation.

Conclusions: The most important task is to adjust the in-take of micronutrients to maintain balance and prevent deficiency and excess, which is important in the complex therapy of patients.