Evaluation of Relationship between Serum Hemoglobin A۱C Level and Severity of Diabetic Foot Ulcers Based on Wagner Criteria

Introduction: One of the important risk factors for diabetic patients, including foot ulcers, is lack of blood sugar control, the standard criterion for which in the long run is the HbA۱C measurement. Therefore, we examined the relationship between serum hemoglobin A۱C levels and severity of diabetic foot ulcers according to Wagner criteria.Materials and methods: This is a descriptive cross-sectional study. The target population was diabetic patients referred to the hospital, who were admitted to the infectious ward due to diabetic foot ulcers. Hemoglobin A۱C levels were determined in all subjects. The severity of diabetic foot ulcers was then assessed according to Wagner criteria. Data analysis was performed using SPSS software version ۲۶.Results: In this study, ۸۴ patients were included in the study, of whom ۳۹ were female (۴۶.۴%) and ۴۵ were male (۵۳.۶%). Out of ۸۴ patients, ۲ (۲.۴%) had grade ۱ Wagner, followed by ۱۰ (۱۱.۹%) grade ۲, ۲۴ (۲۸.۶%) grade ۳, ۳۵ (۴۱.۷%) grade ۴, and ۱۳ (۱۵.۵%) grade ۵. The mean HbA۱c of patients was ۹.۲۴±۱.۸۷. Its mean in grades ۱, ۲, ۳, ۴, ۵, and ۶ were ۷.۳۵ ± ۰.۳۵, ۸.۳۸ ±۱.۰۷۲, ۸.۷۳±۱.۱۲, ۹.۰۶ ±۱.۲۴ and ۱۱.۶۴ ± ۲.۹۳%, respectively. Elevated HbA۱c was significantly associated with males (P = ۰.۰۳۸) and insulin use (P = ۰.۰۳۸), while elevated HbA۱c was not significantly associated with age, duration of diabetes, underlying disease, and BMI (P> ۰.۰۵).Conclusion: HbA۱c level is a good criterion for evaluating the ulcers incidence and predicting the progression of diabetic foot ulcers in patients. By controlling HbA۱c in the normal range and observing hygienic conditions, the occurrence and progression of diabetic foot ulcers can be prevented.

Keywords:

Diabetic Foot Ulcer , Wagner criterion , HbA۱c