Role of C-reactive Protein (CRP) Levels and Glycemic Control in Outcome of Diabetic Foot Ulcer Healing

C反应蛋白(CRP)水平和血糖控制在糖尿病足溃疡愈合结果中的作用

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Abstract

Background This study focuses on patients with diabetic foot ulcers (DFUs) to assess the association between inflammatory and glycemic markers and ulcer outcomes. Specifically, serum C-reactive protein (CRP) and glycated hemoglobin (HbA1c) levels were analyzed to evaluate their relationship with wound healing and amputation rates. Methods A cross-sectional observational study was conducted at Sree Balaji Medical College and Hospital, enrolling 123 diabetic patients with clinically confirmed foot ulcers. Demographic data, ulcer classification, fasting and postprandial blood glucose, glycated hemoglobin (HbA1c), and CRP levels were recorded and analyzed to determine their correlation with wound healing and clinical outcomes. Results A strong positive correlation was observed between CRP and HbA1c levels (r = 0.72, p < 0.001), indicating that poor glycemic control is closely associated with systemic inflammation and impaired ulcer healing. Patients with persistently elevated CRP values experienced delayed wound closure, higher rates of secondary infection, and greater amputation risk. In contrast, patients maintaining good glycemic control (HbA1c < 7%) demonstrated faster healing, reduced infection rates, and fewer complications. Importantly, CRP levels >10 mg/L were found to be a reliable predictor of non-healing ulcers and major adverse outcomes, suggesting its potential role as a prognostic biomarker in DFU management. Conclusion The study highlights the dual importance of glycemic control and inflammation regulation in optimizing DFU outcomes. Routine CRP monitoring, when integrated with standard diabetic care, may facilitate early risk stratification, guide timely interventions, and reduce the incidence of limb-threatening complications. Further prospective studies are warranted to validate CRP as a prognostic marker and to assess the potential role of targeted anti-inflammatory therapies in improving DFU healing and preventing amputations.

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