Serum vitamin D and diabetic foot complications

Robert M. Greenhagen, Robert G. Frykberg, Dane K Wukich

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Foot complications such as ulceration and neuropathy are common complications of diabetes mellitus (DM). Previous reports have demonstrated a possible increased risk of these complications in diabetic patients with low levels of serum vitamin D.Objectctive: The purpose of this study is to compare serum vitamin D levels in diabetic patients with and without Charcot neuroarthropathy (CN), peripheral arterial disease (PAD), infection (DFI), ulceration (DFU), and peripheral neuropathy (DPN). Design: A retrospective chart review of all patients undergoing foot and ankle surgery with a history of DM over a 13 month period was performed. From this cohort, fifty subjects with CN were matched with 50 without CN and preoperative lab values were compared. A secondary evaluation was performed on the subjects’ other comorbidities including PAD, DFI, DFU, and DPN. Results: Seventy-eight percent of our patients had vitamin D deficiency or insufficiency. Preoperative serum vitamin D levels were not significantly different between diabetic patients with and without CN (p = 0.55). Diabetic patients with PAD (p = 0.03), DFI (p = 0.0006), and DFU (p = 0.04) were all found to have significantly lower serum vitamin D levels than diabetic patients without these complications. Lower levels of serum albumin and higher serum creatinine were also noted with subjects with PAD, DFI, DPN, and DFU. While seasonal serum vitamin D level fluctuation was noted, this difference did not reach statistical significance with the numbers available. Conclusion: We found various lower extremity complications to be associated with low serum vitamin D including PAD, DFI, and DFU. While other studies have questioned the role of vitamin D and CN, we were unable to identify any significant difference between diabetic patients with and without Charcot neuroarthropathy. Level of evidence: Level 2.

Original languageEnglish (US)
Article number1579631
JournalDiabetic Foot and Ankle
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Diabetic Foot
Diabetes Complications
Vitamin D
Peripheral Arterial Disease
Serum
Peripheral Nervous System Diseases
Foot
Vitamin D Deficiency
Ankle
Serum Albumin
Comorbidity
Lower Extremity
Creatinine
Diabetes Mellitus
Infection

Keywords

  • Charcot
  • diabetic foot infection (DFI)
  • diabetic foot ulcer (DFU)
  • diabetic peripheral neuropathy (DPN)
  • neuroarthropathy (CN)
  • peripheral arterial disease (PAD)
  • vitamin D

ASJC Scopus subject areas

  • Internal Medicine
  • Podiatry

Cite this

Serum vitamin D and diabetic foot complications. / Greenhagen, Robert M.; Frykberg, Robert G.; Wukich, Dane K.

In: Diabetic Foot and Ankle, Vol. 10, No. 1, 1579631, 01.01.2019.

Research output: Contribution to journalArticle

Greenhagen, Robert M. ; Frykberg, Robert G. ; Wukich, Dane K. / Serum vitamin D and diabetic foot complications. In: Diabetic Foot and Ankle. 2019 ; Vol. 10, No. 1.
@article{ae20525e8db349028f46accfa53e6a1b,
title = "Serum vitamin D and diabetic foot complications",
abstract = "Background: Foot complications such as ulceration and neuropathy are common complications of diabetes mellitus (DM). Previous reports have demonstrated a possible increased risk of these complications in diabetic patients with low levels of serum vitamin D.Objectctive: The purpose of this study is to compare serum vitamin D levels in diabetic patients with and without Charcot neuroarthropathy (CN), peripheral arterial disease (PAD), infection (DFI), ulceration (DFU), and peripheral neuropathy (DPN). Design: A retrospective chart review of all patients undergoing foot and ankle surgery with a history of DM over a 13 month period was performed. From this cohort, fifty subjects with CN were matched with 50 without CN and preoperative lab values were compared. A secondary evaluation was performed on the subjects’ other comorbidities including PAD, DFI, DFU, and DPN. Results: Seventy-eight percent of our patients had vitamin D deficiency or insufficiency. Preoperative serum vitamin D levels were not significantly different between diabetic patients with and without CN (p = 0.55). Diabetic patients with PAD (p = 0.03), DFI (p = 0.0006), and DFU (p = 0.04) were all found to have significantly lower serum vitamin D levels than diabetic patients without these complications. Lower levels of serum albumin and higher serum creatinine were also noted with subjects with PAD, DFI, DPN, and DFU. While seasonal serum vitamin D level fluctuation was noted, this difference did not reach statistical significance with the numbers available. Conclusion: We found various lower extremity complications to be associated with low serum vitamin D including PAD, DFI, and DFU. While other studies have questioned the role of vitamin D and CN, we were unable to identify any significant difference between diabetic patients with and without Charcot neuroarthropathy. Level of evidence: Level 2.",
keywords = "Charcot, diabetic foot infection (DFI), diabetic foot ulcer (DFU), diabetic peripheral neuropathy (DPN), neuroarthropathy (CN), peripheral arterial disease (PAD), vitamin D",
author = "Greenhagen, {Robert M.} and Frykberg, {Robert G.} and Wukich, {Dane K}",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/2000625X.2019.1579631",
language = "English (US)",
volume = "10",
journal = "Diabetic Foot and Ankle",
issn = "2000-625X",
publisher = "Co-Action Publishing",
number = "1",

}

TY - JOUR

T1 - Serum vitamin D and diabetic foot complications

AU - Greenhagen, Robert M.

AU - Frykberg, Robert G.

AU - Wukich, Dane K

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Foot complications such as ulceration and neuropathy are common complications of diabetes mellitus (DM). Previous reports have demonstrated a possible increased risk of these complications in diabetic patients with low levels of serum vitamin D.Objectctive: The purpose of this study is to compare serum vitamin D levels in diabetic patients with and without Charcot neuroarthropathy (CN), peripheral arterial disease (PAD), infection (DFI), ulceration (DFU), and peripheral neuropathy (DPN). Design: A retrospective chart review of all patients undergoing foot and ankle surgery with a history of DM over a 13 month period was performed. From this cohort, fifty subjects with CN were matched with 50 without CN and preoperative lab values were compared. A secondary evaluation was performed on the subjects’ other comorbidities including PAD, DFI, DFU, and DPN. Results: Seventy-eight percent of our patients had vitamin D deficiency or insufficiency. Preoperative serum vitamin D levels were not significantly different between diabetic patients with and without CN (p = 0.55). Diabetic patients with PAD (p = 0.03), DFI (p = 0.0006), and DFU (p = 0.04) were all found to have significantly lower serum vitamin D levels than diabetic patients without these complications. Lower levels of serum albumin and higher serum creatinine were also noted with subjects with PAD, DFI, DPN, and DFU. While seasonal serum vitamin D level fluctuation was noted, this difference did not reach statistical significance with the numbers available. Conclusion: We found various lower extremity complications to be associated with low serum vitamin D including PAD, DFI, and DFU. While other studies have questioned the role of vitamin D and CN, we were unable to identify any significant difference between diabetic patients with and without Charcot neuroarthropathy. Level of evidence: Level 2.

AB - Background: Foot complications such as ulceration and neuropathy are common complications of diabetes mellitus (DM). Previous reports have demonstrated a possible increased risk of these complications in diabetic patients with low levels of serum vitamin D.Objectctive: The purpose of this study is to compare serum vitamin D levels in diabetic patients with and without Charcot neuroarthropathy (CN), peripheral arterial disease (PAD), infection (DFI), ulceration (DFU), and peripheral neuropathy (DPN). Design: A retrospective chart review of all patients undergoing foot and ankle surgery with a history of DM over a 13 month period was performed. From this cohort, fifty subjects with CN were matched with 50 without CN and preoperative lab values were compared. A secondary evaluation was performed on the subjects’ other comorbidities including PAD, DFI, DFU, and DPN. Results: Seventy-eight percent of our patients had vitamin D deficiency or insufficiency. Preoperative serum vitamin D levels were not significantly different between diabetic patients with and without CN (p = 0.55). Diabetic patients with PAD (p = 0.03), DFI (p = 0.0006), and DFU (p = 0.04) were all found to have significantly lower serum vitamin D levels than diabetic patients without these complications. Lower levels of serum albumin and higher serum creatinine were also noted with subjects with PAD, DFI, DPN, and DFU. While seasonal serum vitamin D level fluctuation was noted, this difference did not reach statistical significance with the numbers available. Conclusion: We found various lower extremity complications to be associated with low serum vitamin D including PAD, DFI, and DFU. While other studies have questioned the role of vitamin D and CN, we were unable to identify any significant difference between diabetic patients with and without Charcot neuroarthropathy. Level of evidence: Level 2.

KW - Charcot

KW - diabetic foot infection (DFI)

KW - diabetic foot ulcer (DFU)

KW - diabetic peripheral neuropathy (DPN)

KW - neuroarthropathy (CN)

KW - peripheral arterial disease (PAD)

KW - vitamin D

UR - http://www.scopus.com/inward/record.url?scp=85061788906&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061788906&partnerID=8YFLogxK

U2 - 10.1080/2000625X.2019.1579631

DO - 10.1080/2000625X.2019.1579631

M3 - Article

C2 - 30815231

AN - SCOPUS:85061788906

VL - 10

JO - Diabetic Foot and Ankle

JF - Diabetic Foot and Ankle

SN - 2000-625X

IS - 1

M1 - 1579631

ER -