Biguetti, Cláudia Cristina

Edwards, Garrett

Elvin, Peter

Fakhouri, Walid

Hanis, Craig

English

Scholarworks@UTRGV Univ. of Texas RioGrande Valley

University of Texas Rio Grande Valley ScholarWorks @ UTRGV School of Podiatric Medicine Publications and Presentations School of Podiatric Medicine 8-4-2023 Glycemic Markers and Insulin-related Parameters in the Progression of Diabetes and Lower Extremities Complications: A Pilot Study in Mexican Americans from Starr County Peter Elvin The University of Texas Rio Grande Valley, peter.elvin@utrgv.edu Garrett Edwards The University of Texas Rio Grande Valley Walid Fakhouri University of Texas Health Science Center at Houston Craig Hanis University of Texas Health Science Center at Houston Cláudia Cristina Biguetti The University of Texas Rio Grande Valley Follow this and additional works at: https://scholarworks.utrgv.edu/sopm_pub  Part of the Podiatry Commons Recommended Citation Elvin, P., Edwards, G., Fakhouri, W., Hanis, C., & Biguetti, C. (2023, August 4). Glycemic Markers and Insulin-related Parameters in the Progression of Diabetes and Lower Extremities Complications: A Pilot Study in Mexican Americans from Starr County. 2023 School of Podiatric Medicine Research Day, Harlingen, TX. https://scholarworks.utrgv.edu/sopm_pub/5 This Conference Proceeding is brought to you for free and open access by the School of Podiatric Medicine at ScholarWorks @ UTRGV. It has been accepted for inclusion in School of Podiatric Medicine Publications and Presentations by an authorized administrator of ScholarWorks @ UTRGV. For more information, please contact justin.white@utrgv.edu, william.flores01@utrgv.edu. • HYPOTHESIS: Disease development and progression to DFU is associated with imbalance in glycemic markers and insulin-related parameters from pre-diabetic to diabetic patients with DFUs.DFUNo DFUNon-diabetic0100200300400Fasting Glucose LevelsPresence of UlcerationGlucose Levels (mg/dL)DFUNo DFUNon-diabetic051015HbA1c LevelsPresence of UlcerationHbA1cDFU D ND DFU D NDDFU D ND**********C) D) E)B)Peter Elvin1*, Garrett Edwards1*, Walid Fakhouri2,Craig Hanis3, Claudia Biguetti11. Department of Surgery and Biomechanics, School of Podiatric Medicine, University of Texas Rio Grande Valley2. Department of Diagnostic and Biomedical Sciences, School of Dentistry at Houston, The University of Texas Health Science Center 3. Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health,  The University of Texas Health Science Center at HoustonGlycemic Markers and Insulin-related Parameters in the Progression of Diabetes and Lower Extremities Complications: A Pilot Study in Mexican Americans from Starr CountyINTRODUCTION/BACKGROUNDACKNOWLEDGMENTAdvisor: claudia.biguetti@utrgv.edu Student: peter.elvin01@utrgv.edu                 1. Yazdanpanah L, et al. (2018). Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)-Two-Year Follow-Up Study. International journal of endocrinology, 2018, 7631659.Laboratory of Regenerative Medicine is supported by SOPM –UTRGV, UT System. Thanks to NIH/NCATS - UL1 Mechanism for the funding.Thank you Dr. Luis Venegas for diabetic foot ulcer photos. Thank you Dr. Hagner Andrade for your support in the poster preparation.RESULTS➢ Analysis of variance (ANOVA )with the post hoc Tukey’s test and Kruskal-Wallis with Dunn’s for significance was used for multiple comparisons.➢ Chi-squared or Fisher's exact test for categorical variables.➢ DFU individuals had elevated FG and HbA1c levels, as well as reduced use of metformin compared to D controls. ➢ Larger sample study would be required to validate our findings to establish if HbA1c, metformin use,  and fasting glucose levels can be used as clinical predictors of diabetes progression into foot ulceration.Figure 2. Diabetic foot ulcer on plantar aspect of hallux.  (Photo Courtesy of Dr. Luis Venegas)Regenerative Medicine Research Laboratory➢ Type 2 Diabetes (T2D) is a chronic disease involving alteration in glucose metabolism and uptake, often resulting in an uncontrolled hyperglycemic state➢ Metabolic alterations can lead to neurologic and vascular compromise, allowing progression into lower extremity complications, like diabetic foot ulcers➢ Research Gap: Guidelines linking glycemic metabolic parameters to disease progression remains limited. The extent to which markers can predict the progression of diabetes to lower limb complications has yet to be fully exploredSTATISTICAL ANALYSIS Figure 1. 15-25% of diabetic patients may develop foot ulcers (1)Figure 3. A) Descriptive analysis for a sample of 48 diabetic individuals (D), 48 non-diabetic individuals (ND), and 24 diabetic foot ulcer individuals (DFU). B) Age of the participants by time of data collection, C) Body Mass Index (BMI) D) Distribution of male and female. Values collected by the time of data collection . IRBs for this study HSC-SPH-06-225 and UTRGV-IRB22-0273CONTACT INFORMATIONREFERENCESHYPOTHESIS AND AIM CONCLUSION/FUTURE WORKPOPULATION AND COLLECTION DATA• AIM: To evaluate metabolic parameters in a Mexican American cohort of diabetics with foot ulcers (DFU), diabetic controls (D), and Non-diabetics (ND) from Starr County.MARKERS MEASURED•Fasting Glucose•HbA1C•Fasting Insulin•Use of Diabetic Medications•Metformin Use•C-Peptide LevelsA)Figure 5. A) Contingency table of metformin use in DFU and D cohorts. B-E) Scatter plot representation with median and standard deviation for glycemic markers in ND (Non Diabetic), D (Diabetic Controls without foot ulcers), and DFU (Diabetics with foot ulcers). Statistical significance (p < 0.05) and demonstrated by symbol *.Figure 4. Depiction of glycemic markers that were statistically significant and insignificant. Green checks indicate significance and red X’s indicate insignificance. M = 58% F = 42%A) B) C)D)NDDDFUDFU = 8.58 ± 1.60D = 7.19 ± 1.91ND = 5.49 ±0.27DFU =  28.50±58.57D = 25.31±24.81ND = 16.05±9.78DFU = 214.3±70.49D = 173.20 ±62.31ND = 100.5 ±8.91DFU = 3.80±2.45D = 4.33±2.31ND = 3.60 ±1.42Normal: < 5.7 %; Pre-diabetes: ≥5.7 and  <6.5%; Diabetes: ≥6.5Normal:< 99 mg/dLPre-diabetes: 100 to 125mg/dL; Diabetes: ≥126 mg/dLNormal: < 20 uU/LNormal: 0.9 to 1.8 ng/ml

Glycemic Markers and Insulin-related Parameters in the Progression of Diabetes and Lower Extremities Complications: A Pilot Study in Mexican Americans from Starr County

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Glycemic Markers and Insulin-related Parameters in the Progression of Diabetes and Lower Extremities Complications: A Pilot Study in Mexican Americans from Starr County

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