HbA1c, Lipid profile disturbances, and ESR in diabetic foot ulcer patients

Abstract

A diabetic foot ulcer is a problem that develops due to peripheral artery disease, neuropathy, and other complications. This study investigated the association of elevated glycated hemoglobin (HbA1c) levels and inflammatory markers, including erythrocyte sedimentation rate (ESR) and blood lipids, during exacerbation of diabetic foot ulcers, and evaluated the relationships among these biochemical variables. We compared patients with diabetic ulcers and apparently healthy controls.

This case-control analytical study was conducted to evaluate the relationship between HbA1c, lipid profile, and inflammatory markers (ESR) among patients. A sample of 106 patients with diabetic foot ulcers and 60 apparently healthy controls was collected between November 2025 and March 2026, in this study conducted at a private diabetic foot clinic and Al-Kindi Teaching Hospital.

The mean of glycated hemoglobin (HbA1c) in patients was 9.59 ± 1.88 %, erythrocyte sedimentation rate (ESR) 91.42 ± 23.01 mm/hr, cholesterol 198.93 ± 46.42 mg/dL, triglycerides 153.31 ± 80 mg/dL, low-density lipoprotein (LDL) cholesterol 78.02 ± 36.14 mg/dL, high-density lipoprotein (HDL) cholesterol 34.59 ± 12.78 mg/dL, and very-low-density lipoprotein (VLDL) cholesterol 32.73 ± 16.02 mg/dL. A significant positive correlation was observed between HbA1c and total cholesterol (r=0.217, P=0.025) as well as between total cholesterol and triglyceride levels (r=0.343, P<0.001). However, no significant correlation was found between ESR and the studied biochemical parameters (P >0.05). Statistical analysis was performed using SPSS version 20, with statistical significance considered at P ≤ 0.05.

The study concluded that an increase in HbA1C% and inflammatory marker (ESR) levels, accompanied by a noticeable decrease in HDL, can serve as an indicator for monitoring and preventing unwanted side effects in diabetic patients, such as foot ulcers.