Short-term glucose variability as a determinant of the healing rate of diabetic foot ulcer: A retrospective study

• Published in: Diabetes & metabolic syndrome clinical research & reviews 2024-03, Vol.18 (3), p.102990-102990, Article 102990
• Main Authors: Caruso, Paola, Scappaticcio, Lorenzo, Gicchino, Maurizio, Castaldo, Filomena, Barrasso, Mariluce, Carbone, Carla, Caputo, Mariangela, Tomasuolo, Maria, Paglionico, Vanda Amoresano, Bellastella, Giuseppe, Maiorino, Maria Ida, Esposito, Katherine
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - analysis; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetic complications; Diabetic Foot - blood; Diabetic foot ulcer; Female; Follow-Up Studies; Glucose variability; Glycated Hemoglobin - analysis; Healing rate; Humans; Male; Middle Aged; Prognosis; Retrospective Studies; Tertiary-care center; Type 2 diabetes; Wound Healing
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2024.102990

The aim of this study was to describe the clinical characteristics of people with diabetic foot ulcer (DFU) according to glucose variability (GV) and to investigate the relationship between GV and DFU outcome in a population with type 2 diabetes (T2D) and DFU. This is a retrospective study of 300 individuals aged 64.3 years (181 males) treated for DFU in a tertiary-care center with a regular follow-up for 6 months. Laboratory measurements and clinical assessments were collected at baseline. According to the coefficient of variation (CV) cut-off (≥36%), people were divided into two groups (low and high GV). Compared with low GV group (n = 245), high GV group (n = 55) had significant longer duration of diabetes [low vs high GV, mean ± Standard Deviation (SD), 17.8 ± 11.8 vs 22.4 ± 10.8, P = 0.012], higher levels of glycated haemoglobin [median (IQR), 7.4 (6.6, 8.8) vs 8.2 (7.0, 9.6), P = 0.010] and urinary albumin excretion [25.2 (11.9, 77.0) vs 48.0 (23.2, 106.0), P = 0.031]. Moreover, 10 days self-monitoring of blood glucose-derived glycemic metrics were significantly different between groups. No differences among clinical features were found. The multiple logistic regression analysis identified CV and SD as negative predictors of healing. In a population of people with T2D and DFU treated in a tertiary-care center, individuals with high GV had a 3-fold higher risk of healing failure, as compared with those with low GV. CV and SD were related to poor healing within 6 months follow-up. •Glucose variability (GV) is an emerging risk factors for chronic vascular diabetic complications.•Adults affected by type 2 diabetes and diabetic foot ulcer (DFU) with high GV have a 3-fold risk of healing failure than those with low GV.•GV indices as coefficient of variation (CV) and standard deviation (SD) are independent predictors of healing failure in adults with type 2 diabetes and DFU.•GV should be a target of therapy in people with type 2 diabetes and DFU to improve their prognosis.