A Prospective Study of Assessment of Anemia and Hypoalbuminemia in a Diabetic Patients with Ulcers

Abstract

Introduction: Diabetic foot ulceration (DFU) continues to be the commonest cause of severe limb ischemia in vascular surgery. Up to 25% of diabetic patients are at risk of developing DFU during their lifetime and poor wound healing is a principle reason for morbidity and mortality.1 Diabetes carries an increased risk of a person undergoing lower extremity amputation over twenty times that of age-matched healthy individuals.2
Materials and methods: 90 patients presenting to with diabetic foot infections were included in the study after oral consent Patients fulfilling the criteria were chosen for the study by simple random sampling. The patient details such as age, sex, and duration of diabetes were collected. At admission, the patients underwent blood tests for hemoglobin, HbA1c and albumin among other tests. These data were collected and tabulated. A hemoglobin cut off level of 12 g/dl was chosen to detect anemia, and albumin levels below 3.5 g/dl were considered as hypoalbuminemia. HbA1c levels of more than 7 g/dl indicated poor glycaemic control. The tabulated data was analysed by descriptive tests such as mean and standard deviation.Results: The patients ranged in age from 21-89 years, with a mean age of 57±16.72 years. 29 (16.57%) were less than 40 years of age while 146 were more than 40 years of age (83.42%) (Table1). 33 (37.7%) patients were female while 56 (62.28%) were males. 10 of the 90 patients (11.42%) had type 1 diabetes mellitus and 80 patients (88.57%) had type 2 diabetes mellitus. The duration of diabetes in these patients ranged from 1 year to 25 years, with a mean duration of 10.75±6.17 years. The values of glycosylated hemoglobin ranged from 5.6 g/dl to 14 g/dl. The mean value of glycosylated hemoglobin was 8.5±2.03 g/dl. Of the 90 patients, 65 (72.57%) had poor glycaemic control with HbA1c levels of more than 7 g/dl while 25 (27.42%) had good glycaemic control.Conclusion: We are concluded that anemia and hypoalbuminemia are common occurrences in patients with diabetic foot ulcers, with males being more commonly affected by both than the females and older age group being more commonly affected than the younger age group. However, further studies on a larger scale are needed for better validation. Also, interventional studies are needed to ascertain the effect of correction of these abnormalities on the prognosis of the ulcer.