Eneroth M, Larsson J, Oscarsson C, Apelqvist J, et al.
Journal of wound care. Date of publication 2004 Jun 1;volume 13(6):230-4.
1. J Wound Care. 2004 Jun;13(6):230-4.
Nutritional supplementation for diabetic foot ulcers: the first RCT.
Eneroth M(1), Larsson J, Oscarsson C, Apelqvist J.
Author information:
(1)Department of Orthopaedics, Malmö University Hospital, Sweden.
magnus.eneroth@ort.lu.se
OBJECTIVE: To determine if oral nutritional supplementation improved wound
healing in malnourished patients with diabetic foot ulcers when compared with a
placebo.
METHOD: This prospective randomised controlled double-blind trial involved
patients aged over 60 with diabetes mellitus and a Wagner grade I-II foot ulcer
of over four weeks' duration. Patients received either 400 ml (400 kcal) oral
nutritional supplementation (n = 26) or 400 ml placebo (n = 27) daily for six
months. Patients were followed monthly for six months and after one and two
years.
RESULTS: A third of the patients were classified as having protein-energy
malnutrition at inclusion, with no difference between the two groups. Critical
leg ischaemia was more common in the intervention group than in the placebo group
(p = 0.008). Nine patients in the intervention group (35%) and four in the
placebo group (15%) dropped out of the study (not significant). Of those who
completed the study, the wound had healed at six months in eight out of 23
patients (41%) (placebo) and in seven out of 17 (35%) (intervention) (not
significant). Twenty-four per cent of patients with protein-energy malnutrition
at inclusion had healed at six months compared with 50% of those without it (not
significant).
CONCLUSION: This is the first study to evaluate the possible benefits of
nutritional supplementation on diabetic foot ulcers. A third of patients were
malnourished. We encountered several methodological problems and were unable to
demonstrate an improved wound healing rate in these patients.
DOI: 10.12968/jowc.2004.13.6.26627
PMID: 15214141 [Indexed for MEDLINE]
Appears in following Topics:
