Micronutrient status in patients with diabetic foot ulcers: A cross-sectional study in Saudi Arabia

J Family Med Prim Care. 2024 Jan;13(1):356-362. doi: 10.4103/jfmpc.jfmpc_1109_23. Epub 2024 Feb 8.

Abstract

Background: Patients with diabetes are at risk for developing diabetic foot ulcers (DFUs). It is recognized that type 2 diabetes (T2D) is distinguished by the loss of vitally important micronutrients because of the metabolic nature of this disease and its associated complexities.

Objective: This study was performed to determine the level of micronutrients in patients with DFUs in Saudi Arabia. From February to May 2022, this descriptive study was conducted, adopting the cross-sectional design and a group of 88 patients with T2D.

Materials and methods: Applying the convenience sampling method, this study was conducted at a tertiary hospital in Riyadh, Saudi Arabia. Data collection was conducted through a standard questionnaire, and details regarding the demographic variables and micronutrient deficiency were collected.

Results: Among the nutritional deficiencies identified, the one with the highest frequency was vitamin D, observed in 43.2% of the patient population; after vitamin D, in order of descent, were low ferritin levels (29.5%), B12 (13.6%), and the folic acid deficiency (12.5%). Folic acid showed a statistically significant difference among patients with cardiovascular disease (CVD) (P = 0.041). Moreover, vitamin B12 showed a significant association among patients who have charcot foot (P = 019) and previous amputation (P = 0.029).

Conclusion: Vitamin B12 deficiency is significantly associated with patients who had an amputation; having charcot foot and folic acid revealed a vital relationship among patients with DFUs having CVD. Comprehensive research is a pressing need to enable deeper awareness of micronutrient deficiencies in patients with diabetes.

Keywords: Diabetic patients; Saudi Arabia; foot ulcers; micronutrient.