Ischemia Modified Albumin in Diabetic Foot Ulcers: Promising Marker or Incomplete Picture?

This letter critically appraises the study by Juttada et al, (doi: 10.1177/15347346251332708) which explored ischemia-modified albumin (IMA) as a marker of healing in diabetic foot ulcers (DFUs). We acknowledge the study's novel contribution through its serial IMA monitoring during treatment and compare it with a growing body of evidence. While the study demonstrates promising clinical applicability, there are important limitations regarding its predictive strength, albumin adjustment, and the influence of oxidative therapies. We suggest that future studies adopt a multi-biomarker approach and address variability in oxidative stress conditions such as those encountered during hyperbaric oxygen therapy.