12 August 2018

This article is published in the Journal of the ASEAN Federation of Endocrine Societies

Journal Issue: Vol 33, No 1 (2018)

Authors: Kim Piow Lim,* Azraai Bahari Nasruddin,* Noraishah Md Rani**

 
Institutions: *Endocrine Unit, Department of Medicine, Hospital Putrajaya, Putrajaya, Malaysia
**Wound Care Unit, Hospital Putrajaya, Putrajaya, Malaysia
 
*This study was presented as oral presentation at the 7th National Wound Conference on 18-20 July 2017 at Everly Hotel, Putrajaya, Malaysia and 19th ASEAN Federation of Endocrine Societies Congress on 9-12 November 2017 at Yangon, Myanmar.
 
Corresponding Author
Kim Piow Lim, MD
Fellow, Endocrine Unit, Department of Medicine
Hospital Putrajaya, Putrajaya Pentadbiran Kerajaan Persekutuan Presint 7
62250 Putrajaya, Wilayah Persekutuan, Putrajaya, Malaysia
Tel. No.: 603-83124200
Fax No.: 603-88880137
E-mail: piow2005@gmail.com
ORCID iD: https://orcid.org/0000-0002-9189-9052
 
e-ISSN 2308-118x
Printed in the Philippines
Copyright © 2018 by the JAFES
Received February 6, 2018. Accepted March 16, 2018.
Published Online First: April 4, 2018.
 
ABSTRACT
Objective. To evaluate the association of glycated haemoglobin (HbA1c) reduction and wound healing in patients with diabetic foot ulcer (DFU).
 
Methodology. A 12-week prospective, non-controlled, interventional study in suboptimal-controlled T2DM patients with DFU was conducted. Antidiabetic medications were adjusted with the aim of at least 1% in relation to patient’s individualised HbA1c target. The wound area was determined by using specific wound tracing. The daily wound area healing rate in cm2 per day was calculated as the difference between wound area at first visit and the subsequent visit divided by the number of days between the two visits.
 
Results. 19 patients were included in the study. There was a significant HbA1c reduction from 10.33 %+1.83% to 6.89%+1.4% (p<0.001) with no severe hypoglycaemia. The median daily wound area healing rate was 0.234 (0.025,0.453) cm2/day. There was a strong positive correlation between these two variables (r=0.752, p=0.01). After dividing the patients into four quartiles based on final HbA1c and comparing the first quartile vs fourth quartile, there was a significant difference in daily wound area healing rates (0.597 vs 0.044 cm2/day, p=0.012).
 
Conclusion. There was a positive correlation between HbA1c reduction and wound healing rate in patients with DFU. Although this is an association study, the study postulated the benefits of achieving lower HbA1c on wound healing rate in DFU which require evidence from future randomised controlled studies.
 
Keywords: diabetic foot ulcer, individualised glycemic intervention, wound healing
 

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