Severity of diabetic foot ulcers at various levels of HbA1c

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus and a leading cause of lower-limb amputation. Poor glycemic control has been implicated in DFU development and progression. This study explored the relationship between HbA1c levels and DFU severity using Wagner's classification among patients with type 2 diabetes. In this cross-sectional study conducted over six months at Liaquat University of Medical and Health Sciences, Jamshoro, 64 patients aged 40-80 years with type 2 diabetes for >5 years and HbA1c >6.5% were enrolled. DFU severity was graded using Wagner's classification (grades 1-5). Glycated hemoglobin (HbA1c) levels were categorized into four groups. Associations were assessed using chi-square tests. Mean age was 59.8 ± 8.7 years, with 60.9% males. Mean HbA1c was 8.9 ± 1.3%. Advanced ulcers (Wagner grades 4-5) were present in 51.5% of patients. Patients with HbA1c >8.5% accounted for 76.9% of those with grade 4-5 ulcers. HbA1c levels were significantly associated with DFU severity (χ²= 28.6, p = 0.002). Higher HbA1c levels were significantly associated with more severe DFUs. Optimizing long-term glycemic control may reduce ulcer severity and related complications.