Association of Glycated Haemoglobin and Body Mass Index with Risk of Diabetic Foot Ulcers: A Retrospective Study

Abstract Introduction: The rising global prevalence of diabetes mellitus, driven by chronic hyperglycaemia, has led to an increased burden of diabetic foot ulcers (DFUs), a major cause of morbidity and limb amputation. Among modifiable risk factors, body mass index (BMI) and glycated haemoglobin (HbA1c) are key indicators linked to the development and progression of DFUs. This study aimed to assess the correlation between DFU risk and HbA1c and BMI levels in diabetic patients. Materials and Methods: This retrospective observational study was conducted over 6 months in the general surgery department of a tertiary care hospital. Thirty-five diabetic patients with clinically diagnosed unilateral or bilateral DFUs were included. Patients with prior foot amputation, wheelchair dependence, psychiatric illness or who declined consent were excluded. Neuropathy, vasculopathy and structural abnormalities were assessed using Semmes-Weinstein monofilament, vibration perception and ankle-brachial pressure index. Multiple regression models were built for HbA1c and BMI, optimised using K-fold cross-validation. Results: Among 35 patients (28 males, 7 females; mean age 53.5 ± 12.3 years), the average diabetes duration was 8.9 ± 6.5 years, with poor glycemic control (mean HbA1c 8.7% ±2.7%). Predictive modelling showed strong correlations for HbA1c ( R ² =0.82) and BMI ( R ² =0.88), highlighting their significant association with DFU development. Conclusion: The study showed strong correlations between elevated HbA1c, BMI and DFU risk, emphasising the importance of glycaemic control and lifestyle interventions in preventing DFUs and supporting a multidisciplinary approach to diabetes care.