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The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial

Author(s): Razzaghi R, Pourbagheri H, Momen-Heravi M, Bahmani F, Shadi J, et al.

Abstract

Objective

This study was conducted to evaluate the effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer (DFU).

Methods

This randomized, double-blind, placebo-controlled trial was performed among 60 patients with grade 3 DFU according to "Wagner–Meggitt’s" criteria. Participants were randomly divided into two groups (each 30 participants) and received either 50,000 IU vitamin D supplements every 2 weeks for 12 weeks (group A) or placebo (group B). Fasting blood samples were taken at study baseline and after 12-week intervention to determine related markers.

Results

After 12 weeks of intervention, compared with the placebo, vitamin D supplementation resulted in a significant reduction in ulcer length (− 2.1 ± 1.1 vs. − 1.1 ± 1.1 cm, P = 0.001), width (− 2.0 ± 1.2 vs. − 1.1 ± 1.0 cm, P = 0.02) and depth (− 1.0 ± 0.5 vs. − 0.5 ± 0.5 cm, P < 0.001), and erythema rate (100% vs. 80%, P = 0.01). In addition, in supplemented patients changes in serum insulin concentration (− 3.4 ± 9.2 vs. + 2.8 ± 9.3 μIU/mL, P = 0.01), homeostasis model of assessment-estimated insulin resistance (− 1.5 ± 4.1 vs. + 1.7 ± 5.1, P = 0.01), the quantitative insulin sensitivity check index (+ 0.006 ± 0.02 vs. − 0.006 ± 0.02, P = 0.03) and HbA1c (− 0.6 ± 0.6 vs. − 0.1 ± 0.5%, P = 0.004) were significantly different from those of patients in the placebo group. Additionally, following supplementation with vitamin D, significant reductions in serum total- (− 15.8 ± 18.9 vs. + 5.3 ± 31.8 mg/dL, P = 0.003), LDL- (− 17.2 ± 19.8 vs. + 2.2 ± 28.6 mg/dL, P = 0.003), total-/HDL-cholesterol ratio (− 1.1 ± 0.8 vs. − 0.2 ± 1.1, P = 0.001), high sensitivity C-reactive protein (hs-CRP) (− 0.4 ± 2.5 vs. + 1.9 ± 4.2 μg/mL, P = 0.01), erythrocyte sedimentation rate (ESR) (− 34.7 ± 32.4 vs. − 18.0 ± 26.6 mm/h, P = 0.03) and plasma malondialdehyde (MDA) concentrations (− 0.7 ± 0.9 vs. − 0.2 ± 0.5 μmol/L, P = 0.008) were seen compared with the placebo.

Conclusions

Overall, vitamin D supplementation for 12 weeks among patients with DFU had beneficial effects on glucose homeostasis, total-, LDL-, total-/HDL-cholesterol, ESR, hs-CRP and MDA levels. In addition, vitamin D may have played an indirect role in wound healing due to its effect on improved glycemic control.

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