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D deficiency may be linked to diabetic foot infections

Posted on: July 19, 2012   by  John Cannell, MD


Foot infections are common problems in persons with diabetes. Dictum has it that diabetics often suffer from foot infections due only to compromised circulation. Minor trauma can lead to a major infection, even foot loss. They can be simple surface infections or go all the way into the bone and account for 20% of all diabetic hospitalizations.

In April of 2012, Dr. Shalbha Tiwari and colleagues from the Banaras Hindu University in India wanted to know if patients with such infections were more likely to suffer from vitamin D deficiency than diabetic patients without infections.

Tiwari S, Pratyush DD, Gupta B, Dwivedi A, Chaudhary S, Rayicherla RK, Gupta SK, Singh SK. Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Br J Nutr. 2012 Apr 3:1-4. [Epub ahead of print]

The authors studied 125 diabetics with foot infections and compared them to 164 diabetics without infections over one year. The patients with infections were four times more likely to be severely vitamin D deficient (<10 ng/ml) and about twice as likely to be moderately deficient (<20 ng/ml).

Reverse causation is one explanation: patients with infections stayed inside more. However, the authors pointed out those patients with infections were more likely to be from rural India than were controls and that outdoor exposure should have been more common in cases than controls. Another explanation is that the infection used up more vitamin D, and so patients with infections had lower levels. The last possible explanation is simply that the lower your vitamin D level, the more at risk you are for an infection.

The authors concluded: “This study opens the issue or recognizing vitamin D deficiency as a possible risk factor for diabetic foot infections and suggests the need for vitamin D supplementation in such patients to prevent or to adjuvant the antibiotic therapy used for control of infection.”

1 Response to D deficiency may be linked to diabetic foot infections

  1. [email protected]

    Thank you, Dr. Cannell. I always appreciate your informative posts.
    Rita Umile

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