Poster Presentation ESA-SRB 2023 in conjunction with ENSA

Vitamin D levels and outcomes of diabetes related foot ulceration (#238)

Nada Bechara 1 2 3 , Jenny Gunton 2 3 4 , Peta Tehan 5
  1. Department of Diabetes and Endocrinology, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia
  2. Westmead Hospital, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
  3. Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
  4. Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
  5. Monash University, Melbourne

Diabetes-related foot ulcers are a common complication of diabetes, with 19-34% of people with diabetes developing a foot ulcer over their lifetime. Vitamin D is known to be important for many bodily processes, however, impacts on healing, specifically for foot ulcers are unknown.

This study aimed to assess serum vitamin D with healing trajectory, amputation, and ulcer size in those with DFU. Participants were sent for routine bloods at baseline encompassing usual blood metrics as well as vitamin D levels. Vitamin D deficiency was classified as less than 50 mmol/L.

One hundred adults (72 males and 28 females) were recruited from Blacktown High Risk Foot Service (HRFS) from August 2021 to October 2022. Average age was 62.47 years and duration of diabetes was 20.6 years. The DFU was present for a median of 60 days (IQR 30-120) prior to initial presentation at the HRFS. There was a 50% deficiency rate of vitamin D, with a median vitamin D of 50 mmol/L. Median HbA1c was 8% and CRP 7 mg/L. CRP was significantly correlated with size at baseline (p=0.022), and amputation or death at end of follow up period (p=0.007). Participants who were vitamin D deficient were more likely to have an increased weight (p=0.033). Serum vitamin D was also correlated with age (p<0.001), HbA1c (p=0.009), and sodium (p=0.025). WIfI score was correlated with amputation or death at end of follow up (p<0.001). There were no correlations between vitamin D and ulcer healing trajectory.

In conclusion, those who are vitamin D deficient are more likely to be heavier, older, and have an increased HbA1c. WIfI scores were indicative of amputation at the end of the study period, confirming the use of the WIfI scoring system for DFU. Larger sample sizes are required to assess any correlations between vitamin D and DFU.