Abstract
Background: Diabetes mellitus is one of the leading chronic conditions worldwide. One of its most debilitating complications is diabetic foot ulcers (DFUs), which appear to have an increased incidence in the Pacific Islands. However, this report has not been studied extensively in Samoa. Nevertheless, DFUs may be prevented through strict glycemic control by hemoglobin A1c (HbA1c) level monitoring.Objective: This study aimed to identify a specific cutoff point for HbA1C to reduce the occurrence of DFUs in patients with type 2 diabetes mellitus (T2DM) admitted to an internal medicine ward in Samoa. Increased HbA1c levels are hypothesized to be strongly associated with DFU development.Methods: A retrospective unmatched case-control study examined 100 patients with T2DM (50 patients with DFUs [case] and 50 patients without DFUs [control]) over four months. Participants were selected by convenience sampling.Results: The HbA1c results were available in 32 cases and 29 controls. The receiver operating characteristic curve showed that the area under the curve was 51% (95% CI, 36%-66%; standard error, 0.075; P = 0.8966), and no cutoff point could be established.Conclusion: The HbA1c is not an ideal test to readily predict DFUs in patients with T2DM.
Highlights
Diabetes mellitus (DM) is a chronic condition of impaired blood glucose control that can lead to microvascular and macrovascular complications
This study aimed to identify a specific cutoff point for hemoglobin A1c (HbA1c) that physicians should be aware of to minimize diabetic foot ulcers (DFUs) occurrence
The mean random blood glucose (RBG) was slightly higher in the case group (18.05) than in the control group (17.43), but the mean HbA1c level was very similar between the two groups (10.6% and 10.7%, respectively)
Summary
Diabetes mellitus (DM) is a chronic condition of impaired blood glucose control that can lead to microvascular and macrovascular complications. The overall production of red blood cells is decreased because of erythropoietin reduction; HbA1c cannot be used reliably Glycemic biomarkers such as glycated albumin and fructosamine indicate the mean blood glucose concentration during the lifespan of total plasma albumin or proteins; their lifespan is roughly three weeks [3]. These tests can be utilized in hemoglobinopathies and anemia, where HbA1c has decreased efficacy [4]. DFUs may be prevented through strict glycemic control by hemoglobin A1c (HbA1c) level monitoring
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