The impact of glycaemic variability on wound healing in the diabetic foot - A retrospective study of new ulcers presenting to a specialist multidisciplinary foot clinic

Diabetes Research and Clinical Practice
Ketan K DhatariyaIan Nunney

Abstract

Glycaemic variability - the visit-to-visit variation in HbA1c - plays a possible role in the development of micro and macrovascular disease in patients with diabetes. Whether HbA1c variability is a factor determining wound healing in diabetic foot ulcers remains unknown. We aimed to determine whether HbA1c variability is associated with foot ulcer healing time. A retrospective analysis of patients presenting to our specialist multidisciplinary foot clinic between July 2013 and March 2015, with at least three HbA1c measurements within five years of presentation and more than two follow-up reviews. HbA1c variation was measured by magnitude of standard deviation. 629 new referrals were seen between July 2013 and March 2015. Of these, 172 patients had their number of days to healing recorded and sufficient numbers of HbA1c values to determine variability. The overall geometric mean days to heal was 91.1 days (SD 80.8-102.7). In the low HbA1c variability group the geometric mean days to heal was 78.0 days (60.2-101.2) vs 126.9 days (102.0-158.0) in the high Hb1Ac variability group (p = .032). Those with low HbA1c (<58 mmol/mol) and low variability healed faster than those with high HbA1c and high variability (73.5 days [59.5-90.8] v...Continue Reading

Citations

Nov 22, 2018·The International Journal of Lower Extremity Wounds·Xue-Lei FuHong-Lin Chen
Aug 14, 2019·Vascular and Endovascular Surgery·Constantine N AntonopoulosGeorge Geroulakos
Sep 22, 2020·Biomarker Insights·Ignacio I Álvarez-RodríguezIza F Pérez-Ramírez
Mar 10, 2020·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·I-Te Lee
Feb 15, 2019·The International Journal of Lower Extremity Wounds·Francisco Javier Álvaro-AfonsoNikolaos Papanas
Oct 24, 2020·The International Journal of Lower Extremity Wounds·Ani S TodorovaTsvetalina I Tankova
Mar 2, 2021·International Journal of Pharmaceutics·Katie GloverDimitrios A Lamprou
Mar 21, 2021·Diabetes & Metabolic Syndrome·Ramya RaviSivasankaran Ponnusankar
Jun 4, 2021·Advances in Wound Care·Javier Aragón-SánchezChristian Murillo-Vargas
Sep 8, 2021·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Ketan DhatariyaIan Nunney
Oct 27, 2021·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Peta Ellen TehanVivienne Helaine Chuter
Dec 21, 2021·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Handan AkilPhilip Burgess

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