November 2017

Variability in glycemic control can help estimate time needed to heal foot ulcers

In the moment: Diabetes

By Jordana Bieze Foster

Glycemic variability—fluctuations in HbA1c level from one visit to another—is significantly associated with foot ulcer healing time in patients with diabetes, according to research from the UK.

Investigators from the University of East Anglia in Norwich retrospectively analyzed data for 172 patients who presented with a diabetic foot ulcer over a two-year period and also had at least three HbA1C assessments within five years of presentation. Glyce­mic variability was defined by the magnitude of standard deviation in HbA1c level.

In patients with low gly­cemic variability, the mean time required for diabetic foot ulcer healing was 78 days, compared with 126.9 days in the group with high glycemic variability; the between-group difference was statistically significant. The findings were epublished in late October by Diabetes Research and Clinical Practice.

Although the authors found that time to healing was more dependent on mean HbA1c level than glycemic variability, the findings suggest assessing glycemic variability can be clinically useful in patients at risk for or with diabetic foot ulcers.


Dhatariya KK, Li Ping Wah-Pun Sin E, Cheng JOS, et al. The impact of glycaemic variability on wound healing in the diabetic foot. A retrospective study of new ulcers presenting to a specialist multidisciplinary foot clinic. Diabetes Res Clin Pract 2017 Oct 31;135:23-29. [Epub ahead of print]

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