Blood sugar control doesn't improve diabetic foot ulcers

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Having a healthy baseline HbA1c reading or improving blood glucose levels did not improve  wound healing time among patients with diabetic foot ulcers, according to a new observational study.

Though chronically high blood glucose levels are known harbingers of wound development, bringing those levels under control didn't speed up healing among 270 patients seen at the Johns Hopkins Multidisciplinary Diabetic Foot and Wound Clinic over a five-year period.

“It is likely that the damage induced by chronic hyperglycemia reaches a point where it cannot be reversed in a relatively short time frame to improve wound healing,” Nestoras Mathioudakis, M.D., MHS, assistant professor of medicine and clinical director, division of endocrinology, diabetes and metabolism at Johns Hopkins University School of Medicine, told Endocrine Today.

In the study, published in Diabetes Care, Mathioudakis said there does not appear to be a clinically meaningful association between baseline or prospective A1C and wound healing in patients with DFUs.

But an A1C change of 0.09 to 2.4 was positively associated with long-term wound healing in a subset of participants with baseline A1C less than 7.5%.

Mathioudakis noted that relaxing glucose control to accelerate wound healing seemed paradoxical and suggested further study to understand the correlation.