Research Article

The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers

Volume: 8 Number: 2 March 21, 2025
TR EN

The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers

Abstract

Aims: Diabetic foot ulcers (DFUs) are a significant complication affecting over 30% of individuals with diabetes, leading to increased morbidity and mortality. This study investigates the relationships between frailty, nutritional status, and quality of life in patients aged 50 and older diagnosed with DFUs. Methods: A total of 100 participants with DFUs were prospectively included in the study, with assessments conducted using the Edmonton Frailty Scale and the Mini Nutritional Assessment Scale. Quality of life was evaluated using the EQ-5D-3L scale. Demographic data, concomitant diseases, medications, HbA1c levels, and participants’ height, weight, and circumferences of the upper arm, calf, and waist were recorded. The data analysis was performed using statistical software. Results: The findings revealed that 50% of patients exhibited varying degrees of frailty, and 85% were at risk of malnutrition. Both frailty and malnutrition were associated with a significant decline in quality of life. Notably, patients with normal nutritional status reported higher quality of life scores compared to those at risk of malnutrition or malnourishment. Conclusion: This study underscores the need for a holistic approach to managing DFUs that integrates frailty and nutritional status assessments. Targeted interventions addressing these factors are essential for improving health outcomes and enhancing the quality of life for individuals living with diabetes. The findings advocate a shift from a narrow focus on wound management to a broader, more comprehensive care strategy.

Keywords

References

  1. Sinclair A, Saeedi P, Kaundal A, Karuranga S, Malanda B, Williams R. Diabetes and global ageing among 65-99-year-old adults: findings from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020;162:108078. doi:10.1016/j.diabres.2020. 108078
  2. Yüceler Kaçmaz H, Kahraman H, Akın S, Sözüer E. The effects of frailty on quality of recovery and complications in older adults undergoing major abdominal surgery: a prospective cohort study. J Health Sci Med. 2023;6(5):1133-1141. doi:10.32322/jhsm.1350264
  3. Bôas NCRV, Salomé GM, Ferreira LM. Frailty syndrome and functional disability among older adults with and without diabetes and foot ulcers. J Wound Care. 2018;27(7):409-416. doi:10.12968/jowc.2018.27.7.409
  4. Aydemir A, Yıldırım Gürkan D, Kapukaya EE, Korkmaz M. The investigation of frailty level and factors affecting frailty in older adults with osteoarthritis; a cross-sectional study on Turkish population. J Health Sci Med. 2024;7(4):387-394. doi:10.32322/jhsm.1453110
  5. Sinclair AJ, Abdelhafiz AH. Unravelling the frailty syndrome in diabetes. Lancet Healthy Longev. 2021;2(11):e683-e684. doi:10.1016/S2666-7568 (21)00256-7
  6. Fernando ME, Blanchette V, Mishra R, et al. Frailty in people with chronic limb threatening ischemia and diabetes-related foot ulcers: a systematic review. Ann Vasc Surg. 2023;89:322-337. doi:10.1016/j.avsg. 2022.09.057
  7. Walsh JW, Hoffstad OJ, Sullivan MO, Margolis DJ. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet Med. 2016;33(11):1493-1498. doi:10.1111/dme. 13054
  8. Maltese G, Basile G, Meehan H, et al. Frailty is associated with impaired diabetic foot ulcer healing and all-cause re-hospitalization. J Nutr Health Aging. 2022;26(2):169-173. doi:10.1007/s12603-022-1726-7

Details

Primary Language

English

Subjects

Clinical Sciences (Other)

Journal Section

Research Article

Publication Date

March 21, 2025

Submission Date

December 26, 2024

Acceptance Date

February 7, 2025

Published in Issue

Year 2025 Volume: 8 Number: 2

APA
Demir, L., Avcı, M., Kahraman, M., & Kılıç, S. (2025). The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers. Journal of Health Sciences and Medicine, 8(2), 262-268. https://doi.org/10.32322/jhsm.1608035
AMA
1.Demir L, Avcı M, Kahraman M, Kılıç S. The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers. J Health Sci Med / JHSM. 2025;8(2):262-268. doi:10.32322/jhsm.1608035
Chicago
Demir, Levent, Mustafa Avcı, Murat Kahraman, and Selahattin Kılıç. 2025. “The Hidden Impact: Frailty and Malnutrition in Patients With Diabetic Foot Ulcers”. Journal of Health Sciences and Medicine 8 (2): 262-68. https://doi.org/10.32322/jhsm.1608035.
EndNote
Demir L, Avcı M, Kahraman M, Kılıç S (March 1, 2025) The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers. Journal of Health Sciences and Medicine 8 2 262–268.
IEEE
[1]L. Demir, M. Avcı, M. Kahraman, and S. Kılıç, “The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers”, J Health Sci Med / JHSM, vol. 8, no. 2, pp. 262–268, Mar. 2025, doi: 10.32322/jhsm.1608035.
ISNAD
Demir, Levent - Avcı, Mustafa - Kahraman, Murat - Kılıç, Selahattin. “The Hidden Impact: Frailty and Malnutrition in Patients With Diabetic Foot Ulcers”. Journal of Health Sciences and Medicine 8/2 (March 1, 2025): 262-268. https://doi.org/10.32322/jhsm.1608035.
JAMA
1.Demir L, Avcı M, Kahraman M, Kılıç S. The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers. J Health Sci Med / JHSM. 2025;8:262–268.
MLA
Demir, Levent, et al. “The Hidden Impact: Frailty and Malnutrition in Patients With Diabetic Foot Ulcers”. Journal of Health Sciences and Medicine, vol. 8, no. 2, Mar. 2025, pp. 262-8, doi:10.32322/jhsm.1608035.
Vancouver
1.Levent Demir, Mustafa Avcı, Murat Kahraman, Selahattin Kılıç. The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers. J Health Sci Med / JHSM. 2025 Mar. 1;8(2):262-8. doi:10.32322/jhsm.1608035

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show







The indexes of the journal are ULAKBİM TR Dizin, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

       images?q=tbn:ANd9GcRB9r6zRLDl0Pz7om2DQkiTQXqDtuq64Eb1Qg&usqp=CAU

500px-WorldCat_logo.svg.png

atifdizini.png

logo_world_of_journals_no_margin.png

images?q=tbn%3AANd9GcTNpvUjQ4Ffc6uQBqMQrqYMR53c7bRqD9rohCINkko0Y1a_hPSn&usqp=CAU

doaj.png  

images?q=tbn:ANd9GcSpOQFsFv3RdX0lIQJC3SwkFIA-CceHin_ujli_JrqBy3A32A_Tx_oMoIZn96EcrpLwTQg&usqp=CAU

ici2.png

asos-index.png

drji.png





The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

COPE-logo-300x199.jpgimages?q=tbn:ANd9GcQR6_qdgvxMP9owgnYzJ1M6CS_XzR_d7orTjA&usqp=CAU

icmje_1_orig.png

cc.logo.large.png

ncbi.pngimages?q=tbn:ANd9GcRBcJw8ia8S9TI4Fun5vj3HPzEcEKIvF_jtnw&usqp=CAU

ORCID_logo.png

1*mvsP194Golg0Dmo2rjJ-oQ.jpeg


Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin,  Index Copernicus, ICI World of JournalsDirectory of Research Journals Indexing (DRJI), General Impact FactorASOS Index, OpenAIRE, MIAR,  EuroPub, WorldCat (OCLC)DOAJ,  Türkiye Citation Index, Türk Medline Index, InfoBase Index


Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.


Journal articles are evaluated as "Double-Blind Peer Review". 

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user.  https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy   https://dergipark.org.tr/tr/pub/jhsm/page/10912

Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


17873

Articles published in Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.