Micronutrient Supplementation in Diabetic Foot Ulcers: Pathophysiological Mechanisms and Therapeutic Potential – An Indian Perspective

Introduction: Diabetic Foot Ulcers (DFUs) are a prevalent complication linked with diabetes, significantly affecting the morbidity of patients, hence extending hospitalization and increasing the propensity for amputation. A majority of patients suffering from non-healing chronic wounds did not respond to conservative treatment regimens of antibiotics and debridement. Nutrition is always essential in the healing process as it enhances immunity to tackle infections. This could be a great adjunct to the more traditional means of treating chronic wounds in patients with diabetes. The aim of the present review is to emphasize the role of nutrition during wound healing, especially DFUs, and explain the mechanisms behind delayed wound healing in diabetes, mainly hyperglycemia, oxidative stress, and vascular insufficiency, while underscoring how targeted nutritional intervention positively affects the outcome of healing. Methods: A comprehensive literature search was conducted using PubMed and Google Scholar, focusing on peer-reviewed English-language articles published in the last 20 years. Studies were included if they examined the pathophysiology of DFUs and the role of nutritional interventions such as functional foods, bioactive compounds, and micronutrients in wound healing. Non-English studies, animal-only research without strong clinical relevance, and articles focused solely on nonnutritional interventions were excluded. Results: We conducted a comprehensive literature search using databases such as PubMed and Google Scholar, selecting articles relevant to the title. This review study has shown that impaired healing processes in patients with DFUs are associated with poor nutritional status along with other contributing factors, such as hyperglycemia, oxidative stress, and vascular insufficiency. Discussion: The use of functional and bioactive compounds, such as polyphenols (including flavonoids, curcumin, and resveratrol), probiotics, prebiotics, aloe vera, honey, and green tea extract; oral nutritional supplementation, including vitamin C, magnesium, vitamin D, zinc, proteins, vitamin A, vitamin E, omega-3 fatty acids, iron, and B vitamins, have been shown to support tissue repair, reduce oxidative stress, and regulate inflammation, ultimately contributing to a decrease in ulcer size and depth. Conclusion: Patients with DFUs necessitate comprehensive multidisciplinary management to optimize wound healing; yet, a critical and often neglected component of this care is their nutritional status. Accordingly, an integrative approach that consists of tailored nutritional interventions may significantly enhance outcomes of healing in patients suffering from DFUs along with conventional treatments.