Hemoglobin A1C predicts healing rate in diabetic wounds

Andrea L. Christman, Elizabeth Selvin, David J. Margolis, Gerald Sylvan Lazarus, Luis Garza

Research output: Contribution to journalArticle

Abstract

Lower-extremity wounds are a major complication of diabetes. Hemoglobin A1c (HbA1c) reflects glycemia over 2-3 months and is the standard measure used to monitor glycemia in diabetic patients, but results from studies have not shown a consistent association of HbA1c with wound healing. We hypothesized that elevated HbA1c would be most associated with poor wound healing. To test this hypothesis, we conducted a retrospective cohort study of 183 diabetic individuals treated at the Johns Hopkins Wound Center. Our primary outcome was wound-area healing rate (cm 2 per day). Calibrated tracings of digital images were used to measure wound area. We estimated coefficients for healing rate using a multiple linear regression model controlling for clustering of wounds within individuals and other common clinic variables. The study population was 45% female and 41% African American, with a mean age of 61 years. Mean HbA1c was 8.0%, and there were 2.3 wounds per individual (310 wounds total). Of all measures assessed, only HbA1c was significantly associated with wound-area healing rate. In particular, for each 1.0% point increase in HbA1c, the daily wound-area healing rate decreased by 0.028 cm 2 per day (95% confidence interval: 0.003, 0.0054, P0.027). Our results suggest that glycemia, as assessed by HbA1c, may be an important biomarker in predicting wound-healing rate in diabetic patients.

Original languageEnglish (US)
Pages (from-to)2121-2127
Number of pages7
JournalJournal of Investigative Dermatology
Volume131
Issue number10
DOIs
StatePublished - Oct 2011

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Hemoglobins
Wound Healing
Wounds and Injuries
Linear Models
Biomarkers
Diabetes Complications
Medical problems
Linear regression
African Americans
Cluster Analysis
Lower Extremity
Cohort Studies
Retrospective Studies
Association reactions
Confidence Intervals
Population

ASJC Scopus subject areas

  • Dermatology
  • Biochemistry
  • Cell Biology
  • Molecular Biology

Cite this

Hemoglobin A1C predicts healing rate in diabetic wounds. / Christman, Andrea L.; Selvin, Elizabeth; Margolis, David J.; Lazarus, Gerald Sylvan; Garza, Luis.

In: Journal of Investigative Dermatology, Vol. 131, No. 10, 10.2011, p. 2121-2127.

Research output: Contribution to journalArticle

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