Original Research

Association of Antioxidant, Inflammatory, and Glycemic Status in Patients with Diabetic Foot Ulcers in Karachi, Pakistan: A Comparative Cross-Sectional Study

Saleem Ullah Abro1
Baqai Medical University Karachi
Qurratulain Saleem2
Karachi Medical and Dental College, Karachi Metropolitan University
Uzma Tasneem2
Karachi Medical and Dental College, Karachi Metropolitan University
Jahanzaib Lashari3
Jhalawan Medical Colege Khuzdar
Beena Zahra2
Karachi Medical and Dental College, Karachi Metropolitan University
Rafay Ahmed Siddiqui1
Baqai Medical University Karachi

✉ Correspondence: Saleem Ullah Abro Email: drsaleemullah@baqai.edu.pk

DOI https://doi.org/10.70302/jpsim.v7i3.2643
Volume: 7, Issue 3 Pages: 225–231 Published: 21 Aug 2026
Received: 02 Feb 2026 Revised: 23 Jun 2026 Accepted: 12 Aug 2026 Published Online: 21 Aug 2026

Abstract

Objectives

To evaluate the association of antioxidant, inflammatory, and glycemic status in Patients with diabetic foot ulcers in Karachi, Pakistan.

Methods

A comparative cross-sectional study was conducted at the Department of Physiology in collaboration with the Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, from June 2023 to June 2024. A total of 138 participants were enrolled and grouped into healthy controls, type 2 diabetics, and type 2 diabetics with foot ulcers. Type 1 diabetic patients were excluded. Glycemic parameters, including fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), the oxidative stress marker superoxide dismutase (SOD), inflammatory biomarkers, including C-reactive protein (CRP), complete blood count parameters, and the neutrophil-to-lymphocyte ratio (NLR) were assessed. SOD was measured by ELISA, HbA1c by HPLC, and CRP by immunoturbidimetry. Statistical analysis was performed using IBM SPSS version 23.0.

Results

Median FBG, HbA1c, SOD, CRP, TLC, neutrophil percentage, lymphocyte percentage, and NLR differed significantly among the three groups by applying the Kruskal–Wallis test, and Dunnett’s T3 post hoc analysis showed a significant difference (p < 0.001) in SOD levels among the three groups. HbA1c (OR=89.0; 95% CI:11.6–680), CRP (OR=1.08; 95% CI:1.02–1.13), and NLR (OR=1.86; 95% CI:1.28–2.71) were significant risk factors for DFU, whereas higher SOD levels (OR=0.87; 95% CI:0.84–0.91) showed a protective association by Multinomial logistic regression.

Conclusion

Poor glycemic control, increased systemic inflammation, and reduced antioxidant defense in DFU patients play a critical role in the development of foot ulcers in diabetic patients.

Keywords
C-reactive protein diabetes mellitus fasting blood sugar foot ulcer and superoxide dismutase.

How to Cite This Article

Abro SU, Saleem Q, Tasneem U, Lashari J, Zahra B, Siddiqui RA. Association of Antioxidant, Inflammatory, and Glycemic Status in Patients with Diabetic Foot Ulcers in Karachi, Pakistan: A Comparative Cross-Sectional Study. J Pak Soc Intern Med. 2026;7(3):225–231. doi:10.70302/jpsim.v7i3.2643

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Conflict of Interest

The authors declare no conflict of interest.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

This research received no specific grant from any funding agency.

Funder information follows the Crossref Funder Registry standard.

Ethics Statement

not_applicable

Conducted in accordance with the Declaration of Helsinki.

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CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.
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