The correlation of fasting blood glucose levels with the severity of diabetic foot ulcers and the outcome of treatment strategies

Background: The prevalence of type 2 diabetes mellitus (T2DM) and related complications are rapidly rising worldwide. Diabetic Foot Ulcer (DFU) carries a high risk of proximal or distal amputation. This study explored the correlation of fasting blood glucose levels with the grades of DFUs and the outcome of treatment strategies offered. Materials and Methods: The data of all consecutive patients admitted to the surgical unit with DFUs was recorded for demographic information, grades of DFUs, fasting blood glucose, limb vascularity, treatment strategies offered and the outcome of treatment were recoded. Results: Of a total of 252 patients, 144 (57.1%) had fasting blood glucose level of ≥ 220 mg (%) and 14 (5.6%) had values between 80-100 mg (%). Majority of patients (131; 51.9%) presented with grades 4 and 5 DFUs. A total of 123 amputations were performed, however, only 83 (32.9%) improved and 154 (61.1%) did not (p value 0.00). Conclusion: In this study the majority of patients had poorly controlled T2DM with advanced stage of DFUs that necessitated amputations. An interdisciplinary approach with optimal control of fasting blood glucose and an early detection and aggressive treatment of tissue infection can reduce the frequency of lower limb amputations and T2DM-related morbidity