Abstract

Association of Indices of Glucose Metabolism with Diabetic Foot Ulcers Nothing Sweet about This: Observations from a Hospital-Based Cross- Sectional Study

Background and Aims: With a lifetime incidence of diabetic foot ulcers as high a 25% for diabetics, early detection of these ulcers is utmost to reduce the morbidity, mortality, and economic burden associated with it. Although the role of glycaemic control in wound healing has been studied, there is limited information on indices of glucose metabolism in predisposing diabetics towards foot ulcers. This study aimed to evaluate the association of Fasting Plasma Glucose (FPG), Postprandial Plasma Glucose (PPPG), HbA1C, and Body Mass Index (BMI) with diabetic foot ulcers. Methods: This is a hospital-based observational study where patients with diabetic foot ulcers were recruited. The diabetic ulcers gradation was according to Wagner’s classification, followed by the collection of detailed demographic, clinical and biochemical. Data were presented as frequency and percentage, mean ± SD, median and interquartile range. Comparison between different ulcer grades was performed with ANOVA and posthoc tests. Results: A total of 93 patients were recruited, with 76% males in the age group of 55.6 ± 9.44. With a median duration of diabetes being eight years, most ulcers (>90%) were in grades 2, 3, and 4. The FPG and PPPG were higher than that recommended by Diabetes standards of care. Although mean BMI was normal, HbA1C was significantly associated with the ulcer grade (p=0.01). Conclusions: HbA1C is a better indicator of the severity of ulcers than FPG, PPPG, and BMI. Regular monitoring of glycaemic status through HbA1C would give a better idea of glycaemic control and regulate the development of microvascular complications.

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