Glycemic Control and Peripheral Arterial Disease in Patients with Diabetic Foot at General Hospital of Orizaba N.1
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Abstract
Introduction: Diabetic foot is one of the most serious complications associated with diabetes mellitus. Peripheral Arterial Disease (PAD) results from structural and functional alterations in the peripheral arteries. Poor glycemic control has been associated with accelerated PAD progression.
Objective: To evaluate the correlation between glycemic control and PAD in hospitalized patients with diabetic foot at the Orizaba Regional General Hospital No. 1.
Methods: A cross-sectional observational study was conducted in 246 patients diagnosed with diabetic foot. Glycemic control was determined using glycosylated hemoglobin (HbA1c), and PAD using the ankle-brachial index (ABI). Correlation tests (Spearman's rank correlation coefficient) and ROC analysis were applied to identify the optimal HbA1c cutoff point as a risk marker for PAD.
Results: The average age was 63 years, and the average duration of type 2 diabetes was 12 years. The mean HbA1c was 9.9%. Peripheral arterial disease (PAD) was identified in 88.6% of patients. A significant negative correlation was found between HbA1c and ankle-brachial index (ABI) (p < 0.001). Patients with PAD had higher HbA1c levels (10.13% vs. 7.83%). HbA1c (OR = 2.28) and smoking (OR = 10.1) were independently associated with PAD. ROC analysis showed an optimal HbA1c cutoff point of ≥ 8.6% (AUC = 0.84).
Conclusions: Poor glycemic control is a factor in the development of PAD in patients with diabetic foot. An HbA1c ≥ 8.6% represents a useful clinical threshold for identifying increased risk, highlighting the need for comprehensive metabolic control interventions
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