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VOLUME 9 , ISSUE 1-4 ( January-December, 2023 ) > List of Articles


Can Glycemic Parameters Predict Causative Pathogen in Diabetic Foot Ulcer?

Naveen Reddy, Kirtilaxmi Benachinmardi, Sangeetha Sampath, Lakshminarayan Sura Anjina

Keywords : Bacterial culture growth, Diabetes, Diabetic foot infection, Fasting blood glucose, Hemoglobin A1c

DOI: 10.5005/jp-journals-10045-00225

License: CC BY-NC 4.0

Published Online: 08-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: About 15% of diabetic patients get affected with a complex and heterogeneous disorder with diabetic foot syndrome (DFS) once in a lifetime. Objectives: To record the pattern of pathogenic infectious agents across various levels of fasting blood glucose (FBS) levels and hemoglobin A1c (HbA1c) in type 2 diabetic foot ulcer patients to determine the better predictor among culture growth and FBS levels. Materials and methods: This is a cross-sectional study at a tertiary healthcare center for the duration of 2 months. Pus from the diabetic foot infection was sent to the microbiology laboratory and processed immediately. Microorganism identification and antibiotic susceptibility testing were carried out as per the standard procedures. At the same time, FBS by spectrophotometric method and HbA1c values [Bio-Rad DIO HbA1c analyzer, by high-performance liquid chromatography (HPLC) method] of all the patients involved in the study were recorded. Results: Maximum patients (81%) had FBS of >126 mg/dL and 58% had HbA1c of ≥10. Gram-negative bacilli (GNB) were 80% and gram-positive cocci (GPC) were 20%. With FBS of <100 mg/dL, culture revealed 50% of Klebsiella spp and 50% of Proteus spp. In FBS of 100–126 mg/dL, P. aeruginosa (50%) was common. In ≥126 mg/dL, along with GNB, GPC was also detected. Conclusion: Fasting blood glucose (FBS) and HbA1c values can be of great help in predicting the organism associated with diabetic foot infections and starting the bacteria-targeted antibiotic therapy to reduce further complications.

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