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

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.