Inflammatory Markers and Diabetic Foot: Their Role in Type 2 Diabetes Patients at H. Adam Malik Hospital
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Introduction. Diabetic foot is a severe complication of type 2 diabetes mellitus, resulting from chronic hyperglycemia, vascular disorders, neuropathy, and infection. Inflammatory markers such as C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), fibrinogen, and D-dimer reflect inflammation and coagulation that worsen diabetic foot conditions. However, data from the local population in Medan remain limited. Methods. This cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, from May to June 2025. Participants were hospitalized patients with type 2 diabetes mellitus, both with and without diabetic foot, recruited by consecutive sampling. Inclusion criteria were patients ≥18 years with type 2 diabetes, with or without diabetic foot (grade II–V). Exclusion criteria included chronic diseases (HIV, malignancy, autoimmune), concurrent infections, use of anticoagulants, NSAIDs, steroids, hormones, immunomodulators, pregnancy, or incomplete records. Data on demographics, HbA1c, CRP, ESR, fibrinogen, and D-dimer were analyzed with significance set at p<0.05. Results. A total of 63 patients were included. BMI showed a significant association with diabetic foot (p<0.05), while age, sex, and HbA1c did not. Levels of CRP, ESR, fibrinogen, and D-dimer were significantly higher in patients with diabetic foot than those without (p=0.001). CRP was also significantly associated with ulcer severity based on Wagner classification. Conclusion. CRP, ESR, fibrinogen, and D-dimer were elevated in diabetic foot patients, with CRP as the strongest predictor of ulcer severity. Monitoring these markers is essential for risk assessment and management of diabetic foot in type 2 diabetes.
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