The Blood Sugar Trends in Patients with Diabetic Foot Ulcers: A Comparative Study before and after Amputation Surgery

Mohammadreza Salehi; Leila Seddigh; Sahar Shafagh; Behshad Pazooki; Minoo Sadat Hajmiri; Banafsheh  Moradmand-Badie; Nasim Khajavi Rad; Seyed Ali Dehghan Manshadi; Seyed Ali Dehghan Manshadi; Nima Bagheri; Mehrnaz Rasolinejad; Seyed Mahmoud  Sajadi Jazi

doi:10.18502/jost.v9i3.13018

Mohammadreza Salehi Associate Professor, Department of Infectious Diseases, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Leila Seddigh Assistant Professor, Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sahar Shafagh Internal Medicine Assistant, Department of Infectious Diseases, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Behshad Pazooki Assistant Professor, Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Minoo Sadat Hajmiri Assistant in Endocrinology and Metabolism, Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Banafsheh Moradmand-Badie General Practitioner, Black Dog Institute (BDI), University of New South Wales (UNSW), Sydney, Australia
Nasim Khajavi Rad Assistant Professor, Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Ali Dehghan Manshadi Associate Professor, Department of Infectious Diseases, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Ali Dehghan Manshadi Associate Professor, Department of Infectious Diseases, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Nima Bagheri Assistant Professor, Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mehrnaz Rasolinejad Professor, Department of Infectious Diseases, Research Center for Antibiotic Stewardship and Anti-Microbial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Mahmoud Sajadi Jazi Associate Professor, Department of Internal Medicine, Endocrinology and Metabolism Ward, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v9i3.13018

Keywords: Diabetic Foot; Amputation; Ulcer; Blood Sugar

Abstract

Background: The diabetic foot is a chronic complication of diabetes. There is a strong relationship between glucose levels, the severity of diabetic foot ulcers (DFUs), and the need for amputation. This study aimed to evaluate the blood sugar (BS) trends before and after surgery in patients with DFU who had been amputated.

Methods: The adult patients who had undergone DFU-related amputation surgery between 2017 and 2020 in Imam Khomeini Hospital Complex, Tehran, Iran, were evaluated. The cases whose BS levels were charted at least three days before and after amputation were recruited. The main data, including hypoglycemia (defined as a blood glucose level < 70 mg/dl) and mean BS and fasting BS (FBS) levels, were recorded. The data were then analyzed and compared before and after amputation.

Results: Of 267 patients reviewed for inclusion criteria, 55 patients were included in the study. Twenty-eight patients (50.9%) were men, and the mean age was 60 years. The mean FBS before and after amputation was 229.5 and 181.3 mg/dl, respectively, and the mean BS before and after amputation was 227.3 and 197.8 mg/dl, respectively. The differences were significant (P < 0.001). Twelve patients (21.8%) before and 21 patients (36.4%) after amputation suffered from hypoglycemia (P = 0.057).

Conclusion: DFU-related amputation is associated with a significant decrease in blood glucose levels and inflammatory indexes. However, it can increase the risk of hypoglycemia during the first three days after the surgery.