Geravand Faezeh, Nasli-Esfahani Ensieh, Montazer Mohsen, Jalalzadeh Moharam, Azadbakht Leila
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2025 Jun 11;20(6):e0323537. doi: 10.1371/journal.pone.0323537. eCollection 2025.
This cross-sectional study aimed to investigate the association between carbohydrate quantity and quality and the size, depth, and Wagner grade of diabetic foot ulcers (DFUs).
The study was conducted on 300 participants with DFUs at the Diabetes Clinic of Tehran University of Medical Sciences. Dietary intake was assessed using three 24-hour dietary recalls. Anthropometric measurements, physical activity levels, and socioeconomic factors were evaluated. The location, Wagner grade, length, width, and depth of the diabetic foot ulcer, were assessed by reviewing the patient's medical records and utilizing the information recorded therein.
The findings indicated that out of all the carbohydrate indices examined, only the ratio of whole grain to total grain intake had a significant association with the length of the diabetic foot ulcer. Specifically, participants who consumed lower amounts of whole grain had larger diabetic foot ulcers compared to those with higher whole grain intake (0.85 Vs 0.54, Pvalue = 0.04). This relationship remained significant even after adjusting for potential confounding factors such as age, gender, total energy intake, smoking, physical activity, good shoe condition, and BMI (0.71 Vs 0.52, Pvalue = 0.03).
The findings emphasize the significant role of whole grain intake in the healing process of DFUs. However, further research with larger sample sizes is needed to investigate the impact of other carbohydrate indices.
本横断面研究旨在调查碳水化合物的量与质与糖尿病足溃疡（DFU）的大小、深度及瓦格纳分级之间的关联。
该研究在德黑兰医科大学糖尿病诊所的300名DFU患者中开展。采用三次24小时饮食回顾法评估饮食摄入量。评估人体测量指标、身体活动水平及社会经济因素。通过查阅患者病历并利用其中记录的信息，评估糖尿病足溃疡的位置、瓦格纳分级、长度、宽度及深度。
研究结果表明，在所有检测的碳水化合物指标中，只有全谷物摄入量与总谷物摄入量的比值与糖尿病足溃疡的长度存在显著关联。具体而言，与全谷物摄入量较高的参与者相比，全谷物摄入量较低的参与者糖尿病足溃疡更大（0.85对0.54，P值 = 0.04）。即使在对年龄、性别、总能量摄入、吸烟、身体活动、良好的鞋类状况及体重指数等潜在混杂因素进行校正后，这种关系仍然显著（0.71对0.52，P值 = 0.03）。
研究结果强调了全谷物摄入在DFU愈合过程中的重要作用。然而，需要进一步开展更大样本量的研究来调查其他碳水化合物指标的影响。
