Evolution of muscle mass and strength in patients admitted for a diabetic foot ulcer.

Abstract

Objective: This study aimed to assess changes in muscle mass and strength in patients hospitalized due to a diabetic foot ulcer, and to evaluate the impact of malnutrition at admission on these parameters.

Methods: This prospective observational cohort study included patients from February 2021 to July 2024. Anthropometric measurements, handgrip strength tests, and impedance analyses were conducted. Diagnosis of malnutrition was based on the Global Leadership Initiative on Malnutrition criteria. All patients received nutritional support during their hospital stay.

Results: Seventy-eight DFU patients (74% men, median age 72 years, median BMI 27.6 kg/m²) were recruited. Half of them was malnourished. Median hospital stay was 28 days. Overall, muscle mass and handgrip strength at admission and discharge did not differ significantly (18.31 ± 2.05 versus 18.08 ± 2.11 kg/m² and 26.02 ± 10.27 versus 26.45 ± 11.45 kg respectively). At admission, muscle mass was 17.25 ± 1.66 kg/m² in malnourished patients versus 19.37 ± 1.85 kg/m² in non-malnourished patients (p < 0.001), muscle strength was 24.82 ± 9.39 kg versus 27.23 ± 11.07 kg respectively (non-significant). Muscle mass change in malnourished patients was -0.039 ± 1.35 versus -0.562 ± 1.21 kg/m² for non-malnourished. Muscle strength change for malnourished patients was 0.4 (-8.3 to 15) and 0 (-2.90 to 2.70) kg for non-malnourished. Both changes were not significantly different.

Conclusion: DFU Patients exhibited no significant changes in muscle mass or strength during hospitalization, regardless of nutritional status at admission. Malnutrition did not significantly affect changes in muscle mass or strength during hospitalization. These findings indicate that the current clinical approach including nutritional counselling and support, appears to stabilize muscle health in this relatively immobile and fragile population.