Abstract

Diabetes causes higher levels of blood glucose and often leads to complications like foot ulcers. Hemoglobin present within the red blood cells (RBCs) combines with blood glucose to form glycated hemoglobin (HbA1c) and its higher levels lead to serious life-threatening conditions. The aim of this study was to investigate the shape and texture features of RBCs among various grades of diabetic foot ulcers (DFUs). The study population ([Formula: see text], age: [Formula: see text] years) was grouped based on Wagner classification. Blood samples (5[Formula: see text]mL) were collected to determine the blood glucose and lipid profiles. A gray-level co-occurrence matrix (GLCM) was applied to obtain the textural information from the microscopic blood smear images. The Pearson test exhibited a negative correlation for HDL ([Formula: see text], [Formula: see text]) against HbA1c. A statistically significant correlation ([Formula: see text]) was observed for area, perimeter, equiv-diameter, convex area, major AL and minor AL against HbA1c. The HDL and RBC morphological features (area, perimeter, equiv-diameter, convex area, major AL and minor AL) exhibited statistically significant differences ([Formula: see text]) between the control and grade-2 groups. The texture features namely contrast ([Formula: see text], [Formula: see text]) and homogeneity ([Formula: see text], [Formula: see text]) exhibited statistically significant differences between the grade-2 and grade-0 subjects, depicting larger texture variations among the DFU subjects. The results affirmed that the features extracted from RBCs differ among various grades of DFUs.

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