PROGNOSTIC EVALUATION OF SOME INDICATORS OF NUTRITIONAL STATUS IN PATIENTS WITH DIABETIC FOOT SYNDROME

Background. One of the most dangerous complications of diabetes mellitus (DM) is damage to the lower extremities, leading to the development of diabetic foot syndrome (DFS) due to the progression of tissue metabolism disorders. For effective care of patients with DFS, it is important to identify patients at risk of malnutrition, apply various methods of diagnosing and assessing nutritional deficiencies. Evaluation of the nutritional status (NS), the degree and type of its violations is important for determining the approach to its correction. Objective. To establish the most significant prognostic criteria of the severity of DFS in patients with DM; to study changes in some indicators of NS. Material and methods. A prospective non-randomized observational study of patients with stage 3 deforming arthrosis of the knee joint, who do not have a history of DM, and those with DM complicated by DFS was conducted. To assess the NS of the patients, biochemical parameters in the blood were determined: the level of hemoglobin, total protein, albumin, total cholesterol, 25-hydroxycalciferol (25(OH)D). Results and conclusions. The NS of the patients without DM and those with DM complicated by DFS had significant differences in terms of patient weight, body mass index, blood levels of total protein, albumin, total cholesterol and 25(OH)D (p<0.01). In patients with DFS, the blood levels of total protein, albumin, total cholesterol and 25(OH) D (p<0.01) were statistically lower. As the severity of the foot soft tissue lesion increased, there was a significant high negative correlation of patients' weight (r =-0.763), body mass index (r =-0.721), blood levels of total protein (r =-0.779), albumin (r =-0.711), total cholesterol (r =-1.089). The level of 25(OH)D content showed an insignificant average negative correlation (r =-0.386; p>0.05). The patients' weight, body mass index, blood albumin and 25(OH) D levels had the highest AUC (0,828) and the greatest statistical diagnostic significance for assessing nutrition of patients with DFS.