Correlation of CRP level with glycemic control in diabetic foot patients and its sequelae

Abstract

Background:Diabetes mellitus is a major public health problem globally and in Indian population and diabetic foot is reported as the most common cause of non-traumatic amputation of the lower limbs in India. There is renewed interest in various inflammatory markers and their association with various chronic complications of diabetes mellitus. There is a scarcity of data on the subject in Indian population.Methods: The current study was a cross sectional study of 100 patients admitted to a Diabetic foot in Department of General Surgery, Stanley medical college and Hospital between January 2012-November 2012. The CRP level and fasting and plasma glucose levels were considered as the relevant variables for statistical analysis.Results:A total of 100 patients were included in the final analysis. The proportion of subjects with Wagners, grade 1, grade 2, 3, 4 and 5 ulcers were 48%, 27%, 16%, 3% and 6% respectively. Among the study population, 73% of patients had CRP value greater than 40 and 27% patients had CRP value less than 40. The proportion of subjects with Higher CRP level (>40) showed increasing trend with increasing level of fasting blood sugar and post prandial blood sugar in the study population. The proportion of people who underwent amputation was 27.5% in people with CRP value >40 and it was only 6.85% of people with CRP value <40, the association between CRP values and amputation was statistically significant. (P value 0.046).Conclusions:The study has established a strong positive association between poor blood sugar control and elevated CRP levels in the study population. The study has also documented a positive association between higher CRP levels and amputation.