Evaluation of Relationship between Serum Hemoglobin A1C Level and Severity of Diabetic Foot Ulcers Based on Wagner Criteria

Introduction: One of the important risk factors for diabetic patients, including foot ulcers, is lack of blood sugar control, the standard criterion for which in the long run is the HbA1C measurement. Therefore, we examined the relationship between serum hemoglobin A1C levels and severity of diabetic foot ulcers according to Wagner criteria. Materials and methods: This is a descriptive cross-sectional study. The target population was diabetic patients referred to the hospital, who were admitted to the infectious ward due to diabetic foot ulcers. Hemoglobin A1C levels were determined in all subjects. The severity of diabetic foot ulcers was then assessed according to Wagner criteria. Data analysis was performed using SPSS software version 26. Results: In this study, 84 patients were included in the study, of whom 39 were female (46.4%) and 45 were male (53.6%). Out of 84 patients, 2 (2.4%) had grade 1 Wagner, followed by 10 (11.9%) grade 2, 24 (28.6%) grade 3, 35 (41.7%) grade 4, and 13 (15.5%) grade 5. The mean HbA1c of patients was 9.24±1.87. Its mean in grades 1, 2, 3, 4, 5, and 6 were 7.35 ± 0.35, 8.38 ±1.072, 8.73±1.12, 9.06 ±1.24 and 11.64 ± 2.93%, respectively. Elevated HbA1c was significantly associated with males (P = 0.038) and insulin use (P = 0.038), while elevated HbA1c was not significantly associated with age, duration of diabetes, underlying disease, and BMI (P> 0.05). Conclusion: HbA1c level is a good criterion for evaluating the ulcers incidence and predicting the progression of diabetic foot ulcers in patients. By controlling HbA1c in the normal range and observing hygienic conditions, the occurrence and progression of diabetic foot ulcers can be prevented.