The Relation between Plasma Homocysteine Levels and Diabetic Foot Ulcer in Egyptian Patients with Type 2 Diabetes

Background: Diabetic foot ulcers and lower-limb amputation account for morbidity, mortality and healthcare expenditures among diabetic patients. Ulceration is the most common precursor to amputation. Diabetic foot ulceration development involves several mechanisms, such as neuropathy, increased biochemical stress, external truma and peripheral artery disease. Most of the studies showed that hypercystinemia is related with microvascular and macrovascular complications in diabetic patients. Hyperhomocysteine is related to poor ulcer healing. Aim of the Work: This study was designed is to evaluate plasma homocysteine levels in patients with D.M. and the potential role of homocysteine in occurrence of diabetic foot ulcer in patients attending the outpatient clinic of National Institute of Diabetes Endocrinology (NIDE). Subjects and Methods: This study was conducted on a total number of 90 subjects which were subdivided as follows: Group I: included 35 type 2 diabetic subjects without foot ulcer. Group II: included 35 type 2 diabetic subjects with foot ulcer. All patients are selected from the outpatient clinic of National Institute of Diabetes and Endocrinology (NIDE) Group III: included 20 normal healthy subjects (as controls). In addition to the routine investigations C-reactive protein, and serum Homocysteine were measured. Results: When we compared group I and group II we found that there was a significant statistical difference between them as regard serum homocysteine, p-value 0.025. When we compared group I and group III, we found that there were a significant statistical differences between them as regard serum homocysteine, p-value 0.025. When we compared group II and group III there were a significant statistical differences between them as regard, serum homocysteine, p-value 0.025. Conclusion: It can be concluded that serum hyperho-mocysteinemia was associated with diabetic patients and carry risk for development of diabetic foot ulcers. However, this finding can be used in the, prevention of the development of diabetic foot ulcer especially if further studies will be done on large scale of diabetic Egyptian patients.