1.The effect of individualised Glycemic intervention on Wound Healing Rate in Diabetic Foot Ulcer (The EIGIFU Study)
Kim Piow Lim ; Azraai Bahari Nasruddi ; Noraishah Md Rani
Journal of the ASEAN Federation of Endocrine Societies 2018;33(1):22-27
		                        		
		                        			Objective:
		                        			To  evaluate  the  association  of  glycated  haemoglobin  (HbA1c)   reduction  and  wound  healing  in  patients  with  diabetic foot ulcer (DFU).
		                        		
		                        			Methodology:
		                        			A 12-week prospective, non-controlled, interventional study in suboptimal-controlled T2DM patients with DFU  was  conducted.  Antidiabetic  medications  were  adjusted  with  the  aim  of  at  least  1%  in  relation  to  patient’s  individualised HbA1c  target. The  wound  area  was  determined  by  using  specific  wound  tracing.  The  daily  wound  area  healing rate in cm2 per day was calculated as the difference between wound area at first visit and the subsequent visit divided by the number of days between the two visits.
		                        		
		                        			Results:
		                        			19 patients  were  included  in  the  study.  There  was  a  significant  HbA1c  reduction  from  10.33  %+1.83% to 6.89%+1.4%  (p<0.001) with  no  severe  hypoglycaemia.  The  median  daily  wound  area  healing  rate  was  0.234  (0.025,0.453)  cm2/day. There  was  a  strong  positive  correlation  between  these  two  variables  (r=0.752,p=0.01).  After dividing the patients into four quartiles based on final HbA1c and comparing the first quartile vs fourth quartile, there was a significant difference in daily wound area healing rates   (0.597 vs 0.044 cm2/day,p=0.012).
		                        		
		                        			Conclusion
		                        			There  was  a  positive  correlation  between  HbA1c  reduction  and  wound  healing  rate  in  patients  with  DFU.  Although this is an association study, the study postulated the benefits of achieving lower HbA1c on wound healing rate in DFU which require evidence from future randomised controlled studies.
		                        		
		                        		
		                        		
		                        			Wound Healing
		                        			
		                        		
		                        	
            

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