Cochrane · systematic review · CD011378
Nutritional interventions for treating foot ulcers in people with diabetes
Moore, ZEH, Corcoran, MA, Patton, D · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
WoundsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
58
current version
GRADE rated
23
No studies
35
Included studies
NR
No studies 35 · 60.3%Ungraded 0 · 0%Very low 23 · 39.7%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time) Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | no estimate extracted | NR | No studies |
Ulcer healing (proportion of ulcers healed) Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | RR 0.8 [0.42, 1.53] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Quality of life Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | no estimate extracted | NR | No studies |
Adverse events (death) Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | RR 0.96 [0.06, 14.6] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Development of any new foot ulcers Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | no estimate extracted | NR | No studies |
Amputation rate Oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements vs placebo | RR 4.82 [0.24, 95.88] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time) Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | no estimate extracted | NR | No studies |
Ulcer healing (proportion of ulcers healed) Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | RR 1.09 [0.85, 1.4] | 1 study · 270 participants | Very low Downgraded: imprecision, indirectness |
Quality of life Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | no estimate extracted | 1 study · 270 participants | Very low Downgraded: imprecision, indirectness |
Adverse events Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | RR 1.04 | 1 study · 270 participants | Very low Downgraded: imprecision, indirectness |
Amputation rate Arginine, glutamine and β‐hydroxy‐β‐methylbutyrate supplement vs placebo | RR 0.66 [0.16, 2.69] | 1 study · 270 participants | Very low Downgraded: imprecision, indirectness |
220 mg zinc sulphate supplement containing 50 mg elemental zinc versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound length reduction) 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound depth reduction) 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound width reduction) 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | NR | No studies |
Quality of life 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | NR | No studies |
Adverse events 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | NR | No studies |
Amputation rate 220 mg zinc sulphate supplement containing 50 mg elemental zinc vs placebo | no estimate extracted | NR | No studies |
250 mg magnesium oxide supplement versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound length reduction) 250 mg magnesium oxide supplement vs placebo | no estimate extracted | 1 study · 70 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound depth reduction) 250 mg magnesium oxide supplement vs placebo | no estimate extracted | 1 study · 70 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound width reduction) 250 mg magnesium oxide supplement vs placebo | no estimate extracted | 1 study · 70 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) 250 mg magnesium oxide supplement vs placebo | no estimate extracted | NR | No studies |
Quality of life 250 mg magnesium oxide supplement vs placebo | no estimate extracted | NR | No studies |
Adverse events 250 mg magnesium oxide supplement vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers 250 mg magnesium oxide supplement vs placebo | no estimate extracted | NR | No studies |
Amputation rate 250 mg magnesium oxide supplement vs placebo | no estimate extracted | NR | No studies |
1000 mg/day omega‐3 fatty acid from flaxseed oil supplement versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound length reduction) 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound depth reduction) 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound width reduction) 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | NR | No studies |
Quality of life 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | NR | No studies |
Adverse events 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | NR | No studies |
Amputation rate 1000 mg/day omega‐3 fatty acid from flaxseed oil supplement vs placebo | no estimate extracted | NR | No studies |
150,000 IU of vitamin D versus 300,000 IU of vitamin D for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound area) 150,000 IU of vitamin D vs 300,000 IU of vitamin D | MD 0.61 | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) 150,000 IU of vitamin D vs 300,000 IU of vitamin D | no estimate extracted | NR | No studies |
Quality of life 150,000 IU of vitamin D vs 300,000 IU of vitamin D | no estimate extracted | NR | No studies |
Adverse events 150,000 IU of vitamin D vs 300,000 IU of vitamin D | no estimate extracted | NR | No studies |
Development of any new foot ulcers 150,000 IU of vitamin D vs 300,000 IU of vitamin D | no estimate extracted | NR | No studies |
Amputation rate 150,000 IU of vitamin D vs 300,000 IU of vitamin D | no estimate extracted | NR | No studies |
Magnesium and vitamin E co‐supplementation versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound length) Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound depth) Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound width) Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | NR | No studies |
Quality of life Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | NR | No studies |
Adverse events Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | NR | No studies |
Amputation rate Magnesium and vitamin E co‐supplementation vs placebo | no estimate extracted | NR | No studies |
Vitamin D versus placebo for treating foot ulcers in people with diabetes
Population: people with diabetes and foot ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound length reduction Vitamin D vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound depth reduction Vitamin D vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (absolute change in individual parameters of ulcer dimensions over time: mean (SD) cm wound width reduction Vitamin D vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: imprecision, indirectness |
Ulcer healing (proportion of ulcers healed) Vitamin D vs placebo | no estimate extracted | NR | No studies |
Quality of life Vitamin D vs placebo | no estimate extracted | NR | No studies |
Adverse events Vitamin D vs placebo | no estimate extracted | NR | No studies |
Development of any new foot ulcers Vitamin D vs placebo | no estimate extracted | NR | No studies |
Amputation rate Vitamin D vs placebo | no estimate extracted | NR | No studies |