Correlation of Hemoglobin A1c With Wagner Classification in Patients With Diabetic Foot

Farooque, Umar; Lohano, Ashok Kumar; Rind, Sadam Hussain; Rind, Muhammad Saleem; Karimi, Sundas; Jaan, Ali; Yasmin, Farah; Cheema, Omer

doi:10.7759/cureus.9199

Cited by 12 publications

(15 citation statements)

References 10 publications

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“…It should be noted that since the original study objective was to measure IAs in patients with high and low circulating levels of HbA1c, respectively, the patients were selected to have either had HbA1c levels below 53 mmol/mol or above 69 mmol/mol at the time point of screening. Many patients had intermediary levels at the time point of blood sampling, where 23% of the patients with T1D patients and 16% of the patient with T2D patients were poor responders with HbA1c levels ≥ 80 mmol/mol, which is well within the area of 10–30% reported by others [ 56 , 57 , 58 ]. We find it unlikely that our key findings of an association between SNPs in INSR and HbA1c levels and poor glycaemic control, in particular, are affected by the inclusion criteria.…”

Section: Discussionsupporting

confidence: 58%

Influence of Insulin Receptor Single Nucleotide Polymorphisms on Glycaemic Control and Formation of Anti-Insulin Antibodies in Diabetes Mellitus

Massarenti

Aniol-Nielsen

Enevold

et al. 2022

IJMS

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Single nucleotide polymorphisms (SNPs) in insulin and insulin receptor genes may influence the interaction between the two molecules, as may anti-insulin antibodies (IAs), commonly found in patients with type 1 diabetes mellitus (T1D) or type 2 diabetes mellitus (T2D) treated with exogenous insulin. We examined the impact of two SNPs in the human insulin gene (INS), rs3842752 and rs689, and two in the insulin receptor gene (INSR) rs2245649 and rs2229429, on disease susceptibility, glycaemic control, and IAs formation in 100 T1D patients and 101 T2D patients treated with insulin. 79 individuals without diabetes were typed as healthy controls. The minor alleles of rs3842752 and rs689 in INS protected against T1D (OR: 0.50, p = 0.01 and OR: 0.44; p = 0.002, respectively). The minor alleles of both rs2245649 and rs2229429 in INSR were risk factors for poor glycaemic control (HbA1c ≥ 80 mmol/mol) in T1D (OR: 5.35, p = 0.009 and OR: 3.10, p = 0.01, respectively). Surprisingly, the minor alleles of rs2245649 and rs2229429 in INSR associated strongly with the absence of IAs in T1D (OR = 0.28, p = 0.008 and OR = 0.30, p = 0.002, respectively). In conclusion, the minor alleles of the investigated INS SNPs protect against T1D, and the minor alleles of the investigated INSR SNPs are associated with poor glycaemic control and the absence of IAs in T1D.

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Section: Discussionsupporting

confidence: 58%

Influence of Insulin Receptor Single Nucleotide Polymorphisms on Glycaemic Control and Formation of Anti-Insulin Antibodies in Diabetes Mellitus

Massarenti

Aniol-Nielsen

Enevold

et al. 2022

IJMS

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“…In this study, we demonstrated the association of higher HbA1c levels with worse incident LEA risk. All of the above results reinforce the importance of regular monitoring and treatment of hyperglycemia including lifestyle modification and compliance to medication to decrease the incidence of LEA [ 23 , 31 ].…”

Section: Discussionmentioning

confidence: 59%

Development of Predictive Nomograms for Clinical Use to Quantify the Risk of Amputation in Patients with Diabetic Foot Ulcer

Peng

Min

Liao

et al. 2021

Journal of Diabetes Research

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Objective. To determine the novel proposed nomogram model accuracy in the prediction of the lower-extremity amputations (LEA) risk in diabetic foot ulcer (DFU). Methods and Materials. In this retrospective study, data of 125 patients with diabetic foot ulcer who met the research criteria in Zhongnan Hospital of Wuhan University from January 2015 to December 2019 were collected by filling in the clinical investigation case report form. Firstly, univariate analysis was used to find the primary predictive factors of amputation in patients with diabetic foot ulcer. Secondly, single factor and multiple factor logistic regression analysis were employed to screen the independent influencing factors of amputation introducing the primary predictive factors selected from the univariate analysis. Thirdly, the independent influencing factors were applied to build a prediction model of amputation risk in patients with diabetic foot ulcer by using R4.3; then, the nomogram was established according to the selected variables visually. Finally, the performance of the prediction model was evaluated and verified by receiver working characteristic (ROC) curve, corrected calibration curve, and clinical decision curve. Results. 7 primary predictive factors were selected by univariate analysis from 21 variables, including the course of diabetes, peripheral angiopathy of diabetic (PAD), glycosylated hemoglobin A1c (HbA1c), white blood cells (WBC), albumin (ALB), blood uric acid (BUA), and fibrinogen (FIB); single factor logistic regression analysis showed that albumin was a protective factor for amputation in patients with diabetic foot ulcer, and the other six factors were risk factors. Multivariate logical regression analysis illustrated that only five factors (the course of diabetes, PAD, HbA1c, WBC, and FIB) were independent risk factors for amputation in patients with diabetic foot ulcer. According to the area under curve (AUC) of ROC was 0.876 and corrected calibration curve of the nomogram displayed good fitting ability, the model established by these 5 independent risk factors exhibited good ability to predict the risk of amputation. The decision analysis curve (DCA) indicated that the nomogram model was more practical and accurate when the risk threshold was between 6% and 91%. Conclusion. Our novel proposed nomogram showed that the course of diabetes, PAD, HbA1c, WBC, and FIB are the independent risk factors of amputation in patients with DFU. This prediction model was well developed and behaved a great accurate value for LEA so as to provide a useful tool for screening LEA risk and preventing DFU from developing into amputation.

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“…In our study, diabetic neuropathy and vasculopathy were seen more in patients with increased HbA1c, advancing age, increased random blood sugar, and increased duration of diabetes mellitus and showed increased amputation risk in such patients. Farooque et al reported that 26.13% of patients showed foot ulcerations, with nephropathy, peripheral neuropathy, ophthalmopathy, associated hypertension seen in 21.59%, 14.77%, 10.22%, and 15.9%, respectively [8].…”

Section: Discussionmentioning

confidence: 99%

Wagner's Classification as a Tool for Treating Diabetic Foot Ulcers: Our Observations at a Suburban Teaching Hospital

Shah¹,

Inturi²,

Anne³

et al. 2022

Cureus

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The study aims to scale patients with diabetic foot ulcers according to Wagner's classification, measure the various risk factors, study various outcomes and improve the treatment measures. MethodologyThe article presents materials on a prospective observational study of 50 diabetic foot patients with different presentations who underwent stage-specific intervention. ResultsPoor glycemic control, lifestyle factors, and smoking showed increased risks for foot ulcer complications. Diabetic neuropathy and vasculopathy have been significant outcome predictors. As a result, advanced Wagner's grades showed increased amputation risks and multimodal management. ConclusionsStratification of diabetic foot patients and appropriate management based on their Wagner's grade helps reduce amputation rates and mortality. In addition, multimodal management and exceptional attention to diabetes and lifestyle control improve long-term outcomes.

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Correlation of Hemoglobin A1c With Wagner Classification in Patients With Diabetic Foot

Abstract: Open Access Original Article

Cited by 12 publications

References 10 publications

Influence of Insulin Receptor Single Nucleotide Polymorphisms on Glycaemic Control and Formation of Anti-Insulin Antibodies in Diabetes Mellitus

Influence of Insulin Receptor Single Nucleotide Polymorphisms on Glycaemic Control and Formation of Anti-Insulin Antibodies in Diabetes Mellitus

Development of Predictive Nomograms for Clinical Use to Quantify the Risk of Amputation in Patients with Diabetic Foot Ulcer

Wagner's Classification as a Tool for Treating Diabetic Foot Ulcers: Our Observations at a Suburban Teaching Hospital

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