DOI: 10.2337/db23-509-p ISSN: 0012-1797

509-P: There Is No Blood for Improvement—Anemia Cuts Down Healing Chances in Diabetic Foot Patients

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Aim: Anemia is considered a marker of severity of diabetes and diabetic foot syndrome (DFS) but is still controversial if it can be taken as a predictor of negative outcomes in these patients. Our study aimed to evaluate if anemia could be associated with a reduction of healing chances in patients admitted for DFS.

Methods: We retrospectively analysed all patients admitted in our Department in 2021 for DFS, dividing them in two groups according to presence (Group A) or absence (Group B) of anemia, diagnosed on levels of total Hemoglobin (HB) and red blood cells (RBC) below normal values (HB 13 g/dl for men and 12 g/dl for women and RBC 4.5×106/mm3 for men and 4.2×106/mm3 for women). We compared the groups for clinical and demographic characteristics, blood chemistry, procedures and clinical outcomes: healing rate (HR) and recurrences rate (RR). Among anemic patients we compared clinical outcomes according to the reduction of HB or RBC alone or both.

Results: We derived data from 196 patients: 114 patients in Group A [58.1%; age 70.9±10.6 yrs; male/female 75.4/24.6%; DM1/DM2 7.0/93.0%; Hba1c 57.5±18.6 mmol/mol; diabetes duration (DD) 20.1±11.9 yrs] and 82 in Group B (41.8%; age 68.4±10.9 yrs; male/female 61.0/39.0%; DM1/DM2 9.8/90.2%; Hba1c 60.6±16.2 mmol/mol; DD 16.8±11.9 yrs). Group A presented higher (p<0.05) male prevalence and shorter disease duration but no differences in comorbidities, and surgical or vascular procedures. Group A showed a lower HR (55.2% vs 76.8%, p=0.0028) and a higher RR (23.6% vs 17.1%, p<0.002). No difference in terms of HR, HT or R according to the different diagnostic criteria for anemia. In Cox’s logistic regression analysis only anemia negatively affected healing (HR 2.8, CI 95% 1.4-5.4, p=0.0037).

Conclusions: Anemia is associated to a reduction in healing chances in DFS patients and represents an independent predictor of healing failure.


F.Giangreco: None. E.Iacopi: None. V.Malquori: None. L.Pieruzzi: None. C.Goretti: None. A.Piaggesi: None.

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