Correlation of Glycosylated Haemoglobin with Outcome in Diabetic Lower Limb Ulcer Patients

With a lifetime prevalence of 15–25% in the diabetic population, diabetic ulcers are among the most prevalent consequences of the disease. Over the last several decades, significant progress has been made in understanding the etiology and treatment of diabetic ulcers in the lower limbs, yet the therapeutic efficiency of these interventions remains inadequate. Aims: To investigate the relationship between glycosylated hemoglobin and the prognosis of individuals with diabetic lower leg ulcers. Materials and Methods: The following study is a prospective observational study conducted between May 2023 –April 2024 in the department of General surgery in Dr. B.R.A.M.H and Pt JNM medical college Raipur. The duration of the study was one year. Result: The Most common age group was 51-60 years (Mean age - 58.18 +/- 9.215) with a male preponderance of 57.6%. There is no significant association found between age and gender with Hba1c. The majority of participants (54.8%) fell within the HbA1c range of 6.5-8, followed by 29.5% with HbA1c levels greater than 8 but less than 10, a smaller proportion had HbA1c levels below 6.5 (5.7%) or above 10 (10.0%). Out of the 210 cases, wounds healed by granulation tissue formation and epithelialisation in 57 (27.14%) and 32(15.24%) cases, respectively. While 64 patients (30.48%) needed grafting for the covering of the exposed raw area, 57 patients (27.14%) underwent amputations. The organisms that were found in the ulcer bed include different gram negative and gram-positive bacteria. Among the gram-negative bacteria, E. coli and Klebsiella were found in the majority of the cases. As the degree of the glycemic control worsens the leukocyte count is also increasing. There is a significant association between total leukocyte count and glycosylated hemoglobin (p<0.0001) Conclusion: The study found that managing glycosylated hemoglobin is crucial for preventing complications in diabetic foot ulcers. Optimizing glycosylated hemoglobin levels can reduce the severity of diabetic foot ulcers, promote wound healing, and reduce amputation rates.