Vitamin B12 Deficiency and Foot Ulcers in Type 2 Diabetes Mellitus: A Case–Control Study
Received 7 October 2019
Accepted for publication 27 November 2019
Published 6 December 2019 Volume 2019:12 Pages 2589—2596
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Jing Sun
Mohammed Badedi,1 Hussain Darraj,1 Abdulrahman Hummadi,1 Yahia Solan,1 Ibrahim Zakri,1 Abdullah Khawaji,1 Mohammed Daghreeri,1 Ahmed Budaydi2
1Jazan Diabetes & Endocrine Center, Ministry of Health, Jazan, Saudi Arabia; 2Abu Arish General Hospital, Ministry of Health, Hanoi, Saudi Arabia
Correspondence: Mohammed Badedi
Tel +966 559154136
Objective: To assess the association between vitamin B12 deficiency and the development of diabetic foot ulcers (DFU) in type 2 diabetes mellitus (T2DM).
Methods: This is a case–control study that enrolled 323 Saudi adults with T2DM randomly selected from the Jazan Diabetes & Endocrine Center, Saudi Arabia from January 1, 2019, to July 31, 2019. The sample included 108 newly diagnosed cases with DFU and 215 control participants with T2DM unaffected by and free of foot ulcers (1:2 ratio). Logistic regression analysis was performed to determine the DFU predictors and to examine the association of DFU and vitamin B12 deficiency.
Results: The highest DFU rates were found among the male participants and the participants older than 45 years. Neuropathy, vasculopathy, vitamin B12 deficiency, poor glycemic control, poor feet self-care, Charcot foot, physical inactivity, and spending long time standing at work were significantly associated with DFU, and all except physical inactivity and spending long time standing at work were independent predictors of DFU. After adjustment for the covariates, vitamin B12 deficiency was significantly associated with DFU (odds ratio 3.1), indicating that the patients with T2DM and vitamin B12 deficiency had a three times higher risk of developing DFU than those with normal vitamin B12 levels.
Conclusion: Vitamin B12 deficiency had a significant association with DFU among the Saudi participants with T2DM. Establishing the causality and clarifying the biological role of vitamin B12 deficiency in DFU is important aims for future studies.
Keywords: vitamin B12 deficiency, foot ulcer, type 2 diabetes mellitus, Jazan, Saudi Arabia
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