Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, Miguel Hernández University, Alicante, Spain.
Faculty of Medicine, Miguel Hernández University, Alicante, Spain.
Clin Nutr. 2024 Jun;43(6):1516-1521. doi: 10.1016/j.clnu.2024.05.005. Epub 2024 May 6.
BACKGROUND & AIM: To date, there are no studies demonstrating the impact of the Mediterranean diet on the risk of diabetic foot ulcer. The aim of this research was to examine the connection between adherence to the Mediterranean diet and the level of risk of diabetic foot ulcers in individuals with type 2 diabetes.
Observational pilot study collecting sociodemographic, anthropometric, lifestyle, and type 2 diabetes-related data. Loss of protective sensation was assessed using the Semmes Weinstein 5.07-10 g monofilament, considered altered when not perceived in four points. Vascular status was assessed by palpating pulses and ankle-brachial index, indicating peripheral arterial disease if ankle-brachial index was less than 0.9 or if both pulses were absent. Foot deformities were recorded. The risk of diabetic foot ulcers was stratified into two categories: no risk and risk of diabetic foot ulcers. Adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Screener-14 questionnaire (good adherence with score >7).
Of the 174 patients with type 2 diabetes mellitus who participated (61.5% men and 38.5% women) with a mean age of 69.56 ± 8.86 years and a mean duration of type 2 diabetes of 15.34 ± 9.83 years. Non-adherent patients to the Mediterranean diet exhibited a higher association of diabetic foot ulcers (p = 0.030) and a lower average score on the Mediterranean Diet Adherence Screener-14 (p = 0.011). Additionally, a lower incidence of diabetic foot ulcers was observed in those who consumed nuts three or more times a week (p = 0.003) and sautéed foods two or more times a week (p = 0.003). Multivariate analysis highlighted the importance of physical activity (OR = 0.25, 95% CI 0.11-0.54; p < 0.001), podiatric treatment (OR = 2.59, 95% CI 1.21-5.56; p = 0.014), and duration of type 2 diabetes (OR = 3.25, 95% CI 1.76-5.99; p < 0.001) as significantly associated factors related to the risk of diabetic foot ulcers.
Adhering to the Mediterranean diet correlates with a lower incidence of diabetic foot ulcers in individuals diagnosed with type 2 diabetes mellitus. Furthermore, factors such as regular physical activity, podiatric treatment, and the duration of type 2 diabetes mellitus emerge as pivotal in preventing diabetic foot ulcers.
迄今为止，尚无研究表明地中海饮食对糖尿病足溃疡风险的影响。本研究旨在探讨 2 型糖尿病患者中，地中海饮食的依从性与糖尿病足溃疡风险之间的关系。
这是一项观察性试点研究，收集了社会人口统计学、人体测量学、生活方式和 2 型糖尿病相关数据。使用 Semmes Weinstein 5.07-10g 单丝评估保护性感觉丧失，当在四点都无法感知时则认为感觉改变。通过触诊脉搏和踝肱指数评估血管状态，如果踝肱指数<0.9 或两个脉搏都缺失，则表示存在外周动脉疾病。记录足部畸形。将糖尿病足溃疡的风险分为两类：无风险和糖尿病足溃疡风险。采用地中海饮食依从性筛查-14 问卷（得分>7 为良好依从性）评估地中海饮食的依从性。
本研究共纳入了 174 名 2 型糖尿病患者（61.5%为男性，38.5%为女性），平均年龄为 69.56±8.86 岁，2 型糖尿病的平均病程为 15.34±9.83 年。非地中海饮食依从性患者的糖尿病足溃疡发生率更高（p=0.030），地中海饮食依从性筛查-14 的平均得分更低（p=0.011）。此外，每周食用坚果 3 次或以上（p=0.003）和每周食用炒食 2 次或以上（p=0.003）的患者发生糖尿病足溃疡的风险较低。多变量分析突出了体育活动（OR=0.25，95%CI 0.11-0.54；p<0.001）、足病治疗（OR=2.59，95%CI 1.21-5.56；p=0.014）和 2 型糖尿病病程（OR=3.25，95%CI 1.76-5.99；p<0.001）作为与糖尿病足溃疡风险相关的重要因素。
在诊断为 2 型糖尿病的患者中，遵循地中海饮食与较低的糖尿病足溃疡发生率相关。此外，定期体育活动、足病治疗和 2 型糖尿病病程等因素在预防糖尿病足溃疡方面至关重要。
