The Inlfuence Of Diabetes Fluctuated Blood Glucose Io Patients With Diabetic Foot

Part1. Investigating the risk factors on different Wagner grading in type2diabetes patients with diabetic footObjective To identify risk factors for the occurrence and development ofdiabetic foot in patients with type2diabetes mellitus.Methods A total of767cases of type2diabetic patients, according to whetherthe patient has diabetes foot and diabetic foot severity, were divided into4groups.The0group was non-diabetic foot （NDF） with a total of192cases; The1^st,2^ndand3^rdgroups were the diabetic foot patients with a total of575cases. Thepatients in the1stgroup had the involvement of the tendon or deep subcutaneoustissue （Wagner1²）, with a total of215cases; the patients in the2ndgroup hadthe involvement of bone tissue （Wagner3）, with a total of188patients; thepatients in the3rdgroup had foot gangrene （Wagner4⁵）, with a total of172patients. Comparisons were made between two groups in gender, age, duration ofdiabetes, blood pressure, serum uric acid, serum creatinine, blood urea nitrogen,total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL）, lowdensity lipoprotein （LDL）, high sensitivity C reactive protein （hsCRP）, serumtotal protein, serum albumin, and albumin/creatinine ratio, and DF independentrisk factors was analyzed.Results Compared with group NDF, the patients in the1^st,2^ndand3^rdgroup hadolder age, longer diabetes duration, decreased serum albumin and TG, increased Alb/Cr, but the patients in the2^ndand3^rdgroup had decreased serum total proteinand increased sCr level, while the patients in3^rdgroup had decreased TC and LDL,and elevated serum uric acid, P<0.05. Compared with the1stgroup, the2ndand3rdgroup had reduced LDL level, but the patients in the3^rdgroup had decreased TClevel, P<0.05. The hsCRP level in the0,1^st,2^nd, and3^rdgroup were significantlydifferent between the two groups （P<0.05）. There were no significant difference（P>0.05） between two group in the blood pressure, blood urea nitrogen, and HDLlevel. Logistic regression analysis showed that hsCRP, Alb/Cr, serum albumin isthe independent risk factor of diabetic foot.Conclusion The concentration of hsC-RP，Alb/Cr, and serum albumin may beassociated with the occurrence of diabetic foot and is closely related to theprogression. Part2. Blood glucose fluctuation had an effect role in the diabetic foot withdifferent Wagner grading and amputationObjective To determine the effects of glucose fluctuation on different Wagnergrading and amputation of diabetic foot.Methods A total of767cases of type2diabetic patients, according to whetherthe patient has diabetes foot and diabetic foot severity, were divided into4groups.The patients in the0group were non-diabetic foot （NDF） patients with192cases;the patients in the1^st,2^nd, and3^rdgroup had diabetic foot with575cases. Thepatients in the1stgroup had the involvement of the tendon or deep subcutaneoustissue （Wagner1²）, with a total of215cases; the2^ndgroup had the involvement of bone tissue （Wagner3）, with188patients; the patients in the3nd group hadfoot gangrene （Wagner4⁵）, with a total of172patients. The comparisons weremade between two groups in standard deviation of blood glucose （SDBG）, largestamplitude of glycemic excursions （LAGE）, and fasting plasma glucose variationcoefficient（CV-FPG）. The patients were divided into three groups, i.e. NDF，DFwith and without amputation. Blood glucose fluctuation index was studiedbetween two groups. The independent risk factors were analyzed in the DFdifferent Wagner grading and amputation.Results There were statistically significant difference in SDBG, CV-FPG betweenDF group and NDF group, P<0.05. LAGE in the3rdgroup was greater than in the0group, P<0.05.The difference was also significant in SDBG，CV-FPG betweeneach two groups, P<0.05. Compared to NDF group, the DF with amputationgroup had significantly increased fluctuations in SDBG, CV-FPG and LAGE,P<0.05. SDBG in DF non amputation group and DF amputation group also hasthe difference, P<0.05.Logistic regression analysis showed that SDBG、CV-FPGare the independent risk factors for diabetic foot. SDBG is the important factorinvolved in deteriorating to amputation from the ulcers.Conclusion The fluctuations in SDBG，CV-FPG may be associated with theoccurrence of DF and is closely related to the DF development. SDBG is theindependent risk factors to amputation from DF.