HbA1c as a marker to reduce lower limb amputation in patients with type 2 diabetes mellitus

Abstract

Background: Diabetes mellitus is one of the most serious and prevalent chronic diseases worldwide. One of the most common complications of diabetes in the
lower extremity is the diabetic foot ulcer which is the precursor to ~85% of lower extremity amputations in persons with diabetes.
Materials and Subjects: This is a case- control study which was carried out at Jabir Abu-Aliz
Specialized Center, Khartoum State, Sudan between October 2006 and
April 2007. Forty type 2 diabetes cases with septic foot (group 1 cases), 40 type 2 diabetes cases without septic foot (group 2 cases), and 40 healthy controls participated in this study. Their demographic data were collected. Serum HbA1c levels were estimated by affinity chromatography method.
Results: The level of HbA1c was 9.947±1.40%, 7.908±0.45% and 6.462±0.07%. in group 1, group 2, and the healthy control respectively. There was significant increase in percentage level of HbA1c in group 1 cases compared to group 2 cases and healthy control (p = 0.002, 0.001 respectively). We found very low correlation between fasting blood sugar and HbA1c in group 1 cases (r = + 0.331; p=0.042).
Conclusion: This study indicates that the progression to the complication of foot ulcer in type 2 diabetic patients was correlated to the level of HbAlc. These data may suggest a beneficial effect of considering measurement of HbA1c as a routine test especially for elderly diabetic patients with diabetes for long period. This may help to maintain blood glucose levels in the normal or near normal range and to provide an opportunity for patients to live out their normal life expectancies with minimal complications.

Keywords: glycohemoglobin, neuropathy, septic foot, glycemic control.

Sudan Journal of Medical Sciences Vol. 3 (3) 2008: pp. 227-232