Hubungan Penanda Inflamasi dengan Kejadian Kaki Diabetik pada Pasien Diabetes Melitus Tipe 2 di RSUP H. Adam Malik

Abstract

Background 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, between May and June 2025. The inclusion criteria in this study were patients over 18 years old, either newly or previously diagnosed with type 2 diabetes mellitus, with or without diabetic foot complications (grade II–V), who were hospitalized at Adam Malik Hospital. The exclusion criteria included patients with a history of other chronic diseases such as HIV, malignancies, autoimmune disorders, and other infections; patients taking anticoagulant drugs, NSAIDs, steroids, hormonal therapy, or immunomodulators; pregnant women; and patients with incomplete medical records. Demographic data, HbA1c levels, and concentrations of CRP, ESR, fibrinogen, and D-dimer were analyzed using appropriate statistical tests based on data distribution, with statistical significance set at p<0.05 Result A total of 63 patients were included in the analysis. There was a significant association between body mass index (BMI) and diabetic foot (p<0.05) but no significant associations were found between age, sex, or HbA1c levels and the occurrence of diabetic foot. However,Levels of CRP, ESR, fibrinogen, and D-dimer were significantly higher in patients with diabetic foot compared to those without (p=0.001). CRP levels were also significantly associated with the severity of ulcers based on the Wagner classification. Conclusion Inflammatory markers including CRP, ESR, fibrinogen, and D-dimer were significantly elevated in patients with diabetic foot, with CRP emerging as the strongest predictor of wound severity. Monitoring these biomarkers is crucial for risk assessment and management of diabetic foot in patients with type 2 diabetes mellitus.