Abstract
Background: Micronutrients are required by organisms in trace concentrations sufficient to maintain homeostasis. Deficiency of these elements could result in different medical and metabolic abnormalities. There are limited data on micronutrient status in type 2 diabetics with foot ulcer (DM+FU). Premised on this, this study investigated micronutrient levels of DM+FU and examined their effects on glycaemic indices.
Methods: One hundred and twenty participants, comprising seventy DM+FU and fifty non-diabetic participants (controls) aged 40-60 years, were recruited for the study. Ten millilitres of fasting blood samples were collected from each participant after obtaining their consent and levels of vitamin C, vitamin E, copper, selenium, zinc, FPG and HbA1c were measured. The data were analyzed using ‘t’-test and Pearson’s correlation coefficients. Statistical significant was considered at p<0.05.
Results: FPG and HbA1c were significantly higher in DM+FU (12.98±0.43 mmol/l; 8.63±0.24 %) than in controls (5.09±0.08 mmol/l; 4.08±0.11 %). Vitamin C (3.76±0.43 vs. 5.57±0.43 µmol/l; p=0.003), vitamin E (19.57±1.01 vs. 25.57±0.27 µmol/l; p=0.000) and selenium (0.48±0.01 vs. 0.81±0.04 µmol/l; p=0.000) were substantially lower in DM+FU compared with controls. However, no significant changes were observed when levels of copper and zinc were compared in all participants. Data revealed inverse associations between micronutrients and glycaemic indices (vitamin C/FPG: (r= 0.250, p=0.037); Cu/HbA1c: (r= 0.131, p=0.365)).
Conclusions: Diabetics with foot ulcer were observed to be deficient in selenium, vitamin C and vitamin E. Therefore, type 2 diabetics with foot ulcer should be advised and encouraged to take more of leafy green vegetables and unsweetened fruits.
Keywords: Micronutrient, vitamins, diabetic foot ulcer, glycaemic indices
Résumé
Contexte: Les micronutriments sont requis par les organismes dans les traces de concentrations suffisantes pour maintenir l’homéostasie. L’insuffisance de ces éléments pourrait entraîner des différentes anomalies médicales et métaboliques. Il existe peu de données sur l’état de micronutriment dans les diabétiques de type 2 avec ulcère du pied (DM + FU). Fondé sur ceci, cette étude a investigué les niveaux en micronutrimentsde DM + FU et a examiné leurs effets sur les indices glycémiques.
Méthodes: Cent vingt participants, comprenant soixante-dix DM + FU et cinquante participants non diabétiques (contrôles) âgés de 40-60 ans, ont été recrutés pour l’étude. Dix millilitres d’échantillons de sang jeûné ont été prélevés sur chaque participant après avoir obtenu leur consentement et les niveaux de vitamine C, vitamine E, cuivre, sélénium, zinc, FPG et HbA1c ont été mesurés. Les données ont été analysées à l’aide du test’t’- et les coefficients de corrélation de Pearson. Statistique significative a été considéré à p <0,05.
Résultats: FPG et HbA1c étaient significativement plus élevés dans les DM + FU (12,98 ± 0,43 mmol/l; 8,63 ± 0,24%) que chez les témoins (5,09 ± 0,08 mmol/l; 4,08 ± 0,11%). La vitamine C (3,76 ± 0,43 vs 5,57 ± 0,43 pmol/l; p = 0,003), vitamine E (19,57 ± 1,01 vs 25,57 ± 0,27 pmol/l; p = 0,000) et le sélénium (0,48 ± 0,01 vs 0,81 ± 0,04 pmol / l; p = 0,000) étaient sensiblement plus bas parmiles DM + FU par rapport aux témoins. Toutefois, aucune modification significative n’a été observée lorsque les teneurs en cuivre et en zinc ont été comparés dans tous les participants. Les données ont révélé des associations inverses entre les micronutriments et indices glycémiques (vitamine C / FPG: (r = -0,250, p = 0,037); Cu / HbA1c: (r = -0,131, p = 0,365).
Conclusions: Les diabétiques avec l’ulcère du pied ont été observés à avoir une carence en sélénium, vitamine C et vitamine E. Par conséquent, les diabétiques de type 2 avec ulcère du pied doivent être conseillé et encouragé à prendre plus de fruits non sucrés et légumes à feuillesverts.
Mots-clés: Micronutriments, vitamines, ulcère du pied diabétique, indices glycémiques
Correspondence: Dr. Elizabeth B. Bolajoko, Department of Chemical Pathology, College of Medicine, University of Ibadan, Nigeria, E-mail: elizabethbolajoko@yahoo.com; ebbolajoko@comui.edu.ng
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