The Effect of Micronutrient Intake and Supplementation on Prevalent Diabetes-Related Foot Ulcer and Incident Hospitalisation for Diabetes-Related Foot Ulcer in Type 2 Diabetes: The Fremantle Diabetes Study Phase 2.

OBJECTIVE

To determine whether micronutrient intake and/or supplementation is associated with prevalent diabetes-related foot ulcer (DFU) and/or incident hospitalisation for DFU in type 2 diabetes.

RESEARCH DESIGN AND

METHODS

Participants with type 2 diabetes from the community-based Fremantle Diabetes Study Phase II (FDS2; 1499 participants, mean age 65.4 years, 51.8% males, recruited 2008-2011) were followed from entry to first hospitalization for/with DFU, death or 31 December 2016 (whichever came first). Cox proportional hazards modelling identified independent associates of prevalent DFU or first DFU hospitalization.

RESULTS

Self-reported food frequency, including dietary intake of vitamin C, zinc and iron, taking vitamin supplements and B12 and iron levels were not independent associates of either prevalent DFU or incident DFU hospitalisation. Independent associates of prevalent DFU included younger age at diabetes diagnosis, being unmarried, retinopathy, distal symmetrical polyneuropathy (DSPN), previous diabetes-related amputation, peripheral revascularisation or bypass. Incident DFU hospitalisation was independently associated with male sex, marital status, age at diagnosis of diabetes, HbA1c, a history of DFU, a history of peripheral revascularisation/bypass, heart rate, and ln(NT-proBNP).

CONCLUSIONS

Associates of prevalent and incident DFU included traditional risk factors such as DSPN and peripheral arterial disease. There was no association between nutritional status or taking vitamin supplements and prevalent DFU or incident DFU hospitalisation in people with type 2 diabetes.