What is the role of blood tests in the workup for diabetic foot ulcers?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

A complete blood count (CBC) should be performed. Leukocytosis may signal an associated diabetic foot infection. Wound healing is impaired by anemia. In the face of underlying arterial insufficiency, anemia may precipitate rest pain. [36]

A comprehensive metabolic panel should also be obtained. Random glucose levels will demonstrate the adequacy of glycemic control and may be elevated in the setting of infection. Creatinine levels will assess renal function. Low albumin levels are associated with a poorer prognosis for wound healing. [37]

Blood testing should also include an HbA1c assessment, since a normal value is a surrogate marker for wound healing. [38]

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the setting of infection and osteomyelitis. They can be measured serially to determine the efficacy of treatment.

In the setting of infection with systemic inflammatory responses, obtainment of blood cultures and lactic acid assessment are appropriate.


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