Association of Severity of Diabetic Foot Ulcer with Glycated Hemoglobin A1C Levels
Diabetic Foot Ulcer with Glycated HBA1C Levels
DOI:
https://doi.org/10.54393/pjhs.v4i01.497Keywords:
Foot Ulcer, HBA1C, DiabetesAbstract
Diabetic foot ulcer is a well-documented complication of uncontrolled diabetes and its association with the variables involved in Diabetes like FBS, RBS and HBA1C has been thoroughly researched. This research aims to identify the association of diabetic foot ulcer under Wagner classification with HBA1C classes. Objectives: To determine the severity of diabetic foot ulcer at various level of HBA1C and determine the association. Methods: A cross-sectional study with 360 diabetic patients who after giving consent filled questionnaires. The information was analyzed using SPSS v26 (IBM) through Chi Square test. The results were tabulated and inferred from. Results: Our work depicts a statistically significant correlation between grades of diabetic foot ulcer and HBA1C levels of the patients (p-value <0.001). Patients with higher levels of HBA1C suffered foot ulcer of higher grades. Specifically, patients with Grade 1 foot ulcers primarily had HBA1C levels of ≤ 11.00 with 6(50%) falling in the group “7.01-9.00” while patients with Grade 5 ulcers had higher HBA1C levels with bulk of patients having levels of >11.00. Conclusions: This research further supplemented an already strongly established association between uncontrolled diabetes and diabetic foot ulcer. We focused on specifically HBA1C and how increased lab values are linked with different grades of Diabetic Foot ulcer and found a strong association demanding a proactive approach towards patient care and education
References
Blankush JM, Leitman IM, Soleiman A, Tran T. Association between elevated pre-operative glycosylated hemoglobin and post-operative infections after non-emergent surgery. Annals of Medicine and Surgery. 2016 Sep; 10: 77-82. doi: 10.1016/j.amsu.2016.07.025
Gregg FT, O’Doherty K, Schumm LP, McClintock MK, Huang ES. Glycosylated hemoglobin testing in the national social life, health, and aging project. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2014 Nov; 69(Suppl_2): S198-204. doi: 10.1093/geronb/gbu118
Hong LF, Li XL, Guo YL, Luo SH, Zhu CG, Qing P, et al. Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina. Lipids in Health and Disease. 2014 Dec; 13(1): 1-9. doi: 10.1186/1476-511X-13-89
Humphers JM, Shibuya N, Fluhman BL, Jupiter D. The impact of glycosylated hemoglobin and diabetes mellitus on wound-healing complications and infection after foot and ankle surgery. Journal of the American Podiatric Medical Association. 2014 Jul; 104(4): 320-9. doi: 10.7547/0003-0538-104.4.320
Abbas ZG and Archibald LK. Epidemiology of the diabetic foot in Africa. Medical science monitor: International Medical Journal of Experimental and Clinical Research. 2005 Jul; 11(8): RA262-70.
Nikoloudi M, Eleftheriadou I, Tentolouris A, Kosta OA, Tentolouris N. Diabetic foot infections: update on management. Current Infectious Disease Reports. 2018 Oct; 20(10): 1. doi: 10.1007/s11908-018-0645-6
Al-Ayed MY, Ababneh M, Robert AA, Salman A, Al Saeed A, Al Dawish MA. Evaluation of risk factors associated with diabetic foot ulcers in Saudi Arabia. Current Diabetes Reviews. 2019 Jun; 15(3): 224-32. doi: 10.2174/1573399814666180816165848
Raghav A, Khan ZA, Labala RK, Ahmad J, Noor S, Mishra BK. Financial burden of diabetic foot ulcers to world: a progressive topic to discuss always. Therapeutic Advances in Endocrinology and Metabolism. 2018 Jan; 9(1): 29-31. doi: 10.1177/2042018817744513
Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons NB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014 Mar; 37(3): 651-8. doi: 10.2337/dc13-2176
Cohen J. Statistical power analysis for the behavioral sciences. 2ed Edition: Routledge; 2013 May. doi: 10.4324/9780203771587
Jeon BJ, Choi HJ, Kang JS, Tak MS, Park ES. Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation. International Wound Journal. 2017 Jun; 14(3): 537-45. doi: 10.1111/iwj.12642
Shah P, Inturi R, Anne D, Jadhav D, Viswambharan V, Khadilkar R, et al. Wagner's Classification as a Tool for Treating Diabetic Foot Ulcers: Our Observations at a Suburban Teaching Hospital. Cureus. 2022 Jan; 14(1): e21501. doi:10.7759/cureus.21501
Farooque U, Lohano AK, Rind SH, Rind Sr MS, Karimi S, Jaan A, et al. Correlation of hemoglobin A1c with Wagner classification in patients with diabetic foot. Cureus. 2020 Jul; 12(7): e9199. doi:10.7759/cureus.9199.
Little RR and Sacks DB. HbA1c: how do we measure it and what does it mean? Current Opinion in Endocrinology, Diabetes and Obesity. 2009 Apr; 16(2): 113-8. doi: 10.1097/MED.0b013e328327728d
Zubair M, Malik A, Ahmad J. Glycosylated hemoglobin in diabetic foot and its correlation with clinical variables in a north Indian tertiary care hospital. Journal of Diabetes Metabolism. 2015 Jul; 6(7): 1-6. doi: 10.4172/2155-6156.1000571
Sarinnapakorn V, Sunthorntepwarakul T, Deerochanawong C, Niramitmahapanya S, Napartivaumnuay N. Prevalence of diabetic foot ulcers and risk classifications in type 2 diabetes mellitus patients at Rajavithi Hospital. Journal of Medical Association of Thailand. 2016 Feb; 99(2): S99-105.
Christman AL, Selvin E, Margolis DJ, Lazarus GS, Garza LA. Hemoglobin A1c predicts healing rate in diabetic wounds. Journal of Investigative Dermatology. 2011 Oct; 131(10): 2121-7. doi:10.1038/jid.2011.176
Wu L, Hou Q, Zhou Q, Peng F. Prevalence of risk factors for diabetic foot complications in a Chinese tertiary hospital. International Journal of Clinical and Experimental Medicine. 2015Mar; 8(3): 3785-92.
American Diabetes Association. Standards of Medical Care in Diabetes-2019 Abridged for Primary Care Providers. Clinical Diabetes. 2019 Jan; 37(1): 11-34. doi: 10.2337/cd18-0105.
Zubair M and Ahmad J. Plasma Heat Shock Proteins (HSPs) 70 and 47 levels in diabetic foot and its possible correlation with clinical variables in a North Indian Tertiary care hospital. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2015 Oct; 9(4): 237-43. doi: 10.1016/j.dsx.2015.02.015
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments