Background: Diabetic is a chronic metabolic disease with vascular disorder and HDL (High Density Lipoprotein) is a vascular protector acting agent. One of the most difficult complication of diabetics are diabetic foot with often lead to an amputation due to vascular disorder. Objective of this study aims to determine the relationship of HDL levels with diabetic foot severity by comparing HDL levels in each diabetic foot grade according to the Wagner classification.Methods: This is a cross sectional study, with new inpatient and outpatient with diabetic foot ulcer that never received therapy in Wahidin Sudirohusodo Hospital as a study population in April 2018 to June 2018 time period. Frequency distribution, Spearman’s Correlation, Anova, and Chi Square statistical analytic was done with p <0.05 considered as significant.Results: HDL level was wound highest in Grade I and lowest in Grade IV and V. HDL level comparison according to Wagner comparison shows significant difference, p<0.001.Conclusions: There were a negative correlation as an analysis results shows between HDL level and Wagner classification, whereas the lower HDL level, the higher diabetic foot grade and HDL can be used as a prognosis predictor and planning therapy.
Fracture is defined by the loss of bone or cartilage continuity, either total or partial. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. HbA1c could be used as a diagnostic tool and determines the glycaemic control of DM patients. This study aimed to investigate the correlation between serum HbA1c levels and the healing process of postoperative fractures in DM patients. This was an observational study with a retrospective cohort design. The study population was DM patients who were admitted to the Department of Emergency, Dr. Wahidin Sudirohusodo General Hospital, Makassar due to long bone fracture within the period of September 2019-February 2020. The bone fractures healing was evaluated based on the radiographic union scale in tibial fractures (RUST) scores. The results are analysed using the Chi-square test. A total of 70DM patients who underwent fracture reduction surgery were involved in this study. Out of 35 patients with controlled DM (HbA1c <7%), we obtained 24 (68.6%) patients and 11 (31.4%) patients with good and delayed union, respectively. The other 35 patients had uncontrolled DM (HbA1c >7%), and there were 13 (37.1%) patients and 22 (62.9%) patients with good and delayed union, respectively. The Chi-square test showed a significant relationship (p= 0.008). It can be concluded that the increase in HbA1c levels was related to the obstacles in bone fractures healing. Moreover, an infection contributes to the healing status of bone fractures.
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