The hemoglobin A1C (HbA1C) blood test can predict whether partial foot amputation will succeed in diabetics with foot ulcers or whether a below-the-knee amputation will be necessary, according to the findings of a study presented at the American Orthopaedic Foot and Ankle Society's annual meeting (July 29, 2004). Although the finger-stick test diabetics take every day gives a blood-sugar value for that moment, the HbA1C test gives a more long-term assessment of how sugar levels have been controlled over several months. A majority of laboratories consider HbA1C values between 3% and 6% as normal.
In the current study, the researchers compared data from 21 patients with a failed partial foot amputation and 21 similar patients with a successful amputation. Age, sex, smoking, pulse in the foot, and HbA1C were factored into the study. The results showed that an HbA1C value of >10% strongly indicated that a partial foot amputation would fail to heal, compared with values of <7% that usually forecast success. Lead researcher Alastair Younger, MD, stressed, however, that a high HbA1C should not result in an automatic below-the-knee amputation. Instead, surgeons should refer the patient to an endocrinologist or take other steps to improve sugar level prior to surgery.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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