Buerger exercise combined with vitamin D for the treatment of ischemic diabetic foot ulcer

Objective To investigate the improvement effects of Buerger exercise combined with vitamin D supplementation on the healing of diabetic foot ulcers, multi-point skin temperatures of the foot, ankle-brachial index (ABI), glucose and lipid metabolism, and nerve conduction. Methods A total of 102 diabetic foot patients treated at the General Hospital of Taiyuan Iron and Steel (Group) Co., Ltd. from July 2019 to July 2022 were prospectively selected. The patients were randomly divided into three groups (34 patients each): the conventional group, the exercise group, and the combined group. The conventional group received routine comprehensive treatment. In addition to this, the exercise group performed Buerger exercise, and the combined group received Buerger exercise combined with vitamin D supplementation. The outcomes were compared among the three groups, including glucose and lipid metabolism indicators, multi-point skin temperatures of the foot, nerve conduction, ulcer area, ABI, transcuta neous oxygen partial pressure, dorsal foot artery mean blood flow velocity (DAMV), sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV) of the median and peroneal nerves, and safety. Results After 8 weeks of treatment, the levels of the fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin (HbA1c), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and ulcer area decreased in all three groups (P＜0.05). High-density lipoprotein cholesterol (HDL-C), multi-point skin temperatures of the foot, ABI, transcuta neous oxygen partial pressure, DAMV, SCV and MCV of the median and peroneal nerves increased in all three groups (P＜0.05). The improvement was most pronounced in the combined group (P＜0.05). Conclusion Buerger exercise is a quantifiable and safe form of exercise. Combined supplementation of vitamin D in diabetic foot patients can optimize glucose and lipid metabolism, improve foot ischemia and nerve conduction, relieve lower limb pain, and promote ulcer healing.