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

Raedeh Basiri, Maria T Spicer, Thomas Ledermann, Bahram H Arjmandi

Journal: Nutrients 2022;14(17):3564

PMID: 36079822

Plain Language Summary

Diabetic foot ulcers (DFUs) are among the most common complications of uncontrolled diabetes. Nutrition can play a key role in the prevention and improvement of the clinical outcomes of DFUs. The aim of this study was to examine the effects of nutrition education and supplementation on long-term blood glucose control, body composition, and phase angle as an indicator of cellular health and cell membrane integrity in patients with DFUs. This study is a randomised clinical trial in which participants were randomly assigned to either the treatment group (nutritional supplements, diet education, and standard care) or the control group (standard care). Results show that supplementing the diet with extra energy sources and nutrients did not have any negative effects on long-term blood glucose control or the body composition of overweight and obese patients with DFUs when combined with nutrition education. Additionally, the nutrition intervention had some positive effects on the body composition and phase angle of DFU patients in the treatment group. Authors conclude that dietary recommendations for overweight and obese individuals with DFUs should prioritise proper wound healing by recommending that patients consume adequate energy sources and essential nutrients.

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/m for the treatment group and 34.1 kg/m 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.

Address: Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA.; Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA.; Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA.; Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA.; Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA.; Department of Family and Child Sciences, Florida State University, Tallahassee, FL 32306, USA.; Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA.; Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA.

DOI: 10.3390/nu14173564

Patient Centred Factor

Triggers: Nutrition intervention

Clinical Imbalances

Hormonal Immune and inflammation

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet

Jadad Score

Allocation Concealment

Yes

Nutrition Evidence Keywords

Diabetes Inflammation Obese Overweight Glucose Insulin HbA1c Body mass index Supplements Type 2 diabetes Glucose homeostasis Glycated haemoglobin Hormones Body fat Body mass Diabetic Hypermetabolism

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/diabetes.html

MeSH Terms: Adult, Aged, Blood Glucose, Body Composition, Diabetes Mellitus, Diabetic Foot, Humans, Middle Aged, Obesity, Overweight, Wound Healing