Metabolic and Inflammatory Profiles in Patients with Wagner Grade 2–3 Diabetic Foot Ulcer: A Gender-Stratified Analysis
TL;DR
Patients with Wagner grade 2–3 DFU exhibit substantial metabolic and inflammatory disturbances, although gender-related differences were not evident, highlighting the importance of comprehensive biomarker assessment to support clinical evaluation and management.
Abstract
Background: Diabetic foot ulcer (DFU) is a severe complication of type 2 diabetes mellitus (T2DM) associated with impaired wound healing and increased risks of amputation and mortality. Hormonal differences between males and females may influence albumin metabolism, glycemic markers, and inflammatory responses. However, evidence in patients with moderate DFU remains limited. This study aimed to evaluate metabolic and inflammatory profiles and assess gender-related differences in patients with DFU. Methods: A cross-sectional study was conducted among patients with T2DM and Wagner grade 2–3 DFU, representing moderate, non-gangrenous stages of ulcer severity. Eighty patients were enrolled using consecutive sampling at three hospitals in East Kalimantan, Indonesia, from April to December 2025. Serum albumin, glycated albumin (GA), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were measured using standardized automated assays. Descriptive statistics were used to summarize patient characteristics. Gender-stratified analyses were performed using the independent-samples t-test or Mann–Whitney U test. Results: Most participants were female (61.3%) and aged ≥45 years (91.3%). The median serum albumin level was 3.7 g/dL (IQR 3.1–4.1), while the mean GA level was 26.6± 6.7%, indicating poor short-term glycemic control. Median hs-CRP and IL-6 levels were also elevated, indicating persistent systemic inflammation. Female patients had higher hs-CRP and IL-6 levels than male patients; however, no statistically significant gender-related differences were observed in albumin, GA, hs-CRP, or IL-6 levels (p>0.05). Conclusion: Patients with Wagner grade 2–3 DFU exhibit substantial metabolic and inflammatory disturbances, although gender-related differences were not evident. These findings highlight the importance of comprehensive biomarker assessment to support clinical evaluation and management.