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Nutritional Status in diabetic patients with foot ulcers: Bioelectrical Analysis in routine evaluation



Ulceration of the foot in diabetes is common and disabling Diabetic Foot Ulcers (DFU) are a dangerous and invalidating complication of diabetes. Traditionally they are classified by their aetiology, but many other factors may affect their evolution. Anamnestic, anthropometric and laboratory criteria are recommended for evaluation of Nutritional Status. They are suitable in clinical practice, but we argue that they are unfit to identify Malnutrition in specific populations, as DFU patients. Aim of our study was to evaluate the nutritional pattern and some other clinical and laboratory parameters among the ones tested routinarly in ambulatorial setting in a group of type 2 diabetic patients with DFU to characterize and single out the most efficient parameters useful for diagnosis of malnutrition.


23 non healing DFU subjects and 24 type 2 diabetic subjects without DFU, as control. For the evaluation of body composition we used bioelectrical impedance analysis (BIA 101 Akern ®). Phase Angle (pA) was pointed as a marker of extracellular/intracellular water rate and of body cell mass (BCM). We also recorded HbA1c, disease duration, Haemoglobin (Hb), Albumin, Total Proteins, Creatinin, C-Reactive Protein (CRP), BMI and any weight variation in the last two months.


No significant difference for Albumin, Serum Proteins, CRP, Creatinin, Hb was found. Only the pA was significantly reduced (p = 0.001) in DFU subjects. Furthermore, the distribution of BMI and Hb values in reference ranges do not differ in DFU group and in the control group.


The routine clinical and laboratory evaluation tests are not reliable to detect dynamic changes of the nutritional status in DFU subjects whereas bioelectrical measurements are useful in the evaluation of body cell mass changes in these subjects.