Prevention of lower-limb lesions and reduction of morbidity in diabetic patients

Abstract

ObjectiveTo assess the impact of a diabetic foot outpatient clinic on reducing the morbidity of this disease, with emphasis on lower-limb lesions.MethodsThis was a prospective observational study with a target population of 30 cases out of a total of 77 patients in the diabetic foot outpatient clinic. The inclusion criterion was that data relating to laboratory tests, clinical examinations, neuropathic and vascular tests and the elbow-arm index needed to be available from all the patients, with repetition after 18 months of follow-up, so as to analyze their evolution. The statistical analysis was done using the McNemar chi-square test for dependent samples.ResultsThe patients’ mean age was 61 years. All of them had type 2 diabetes mellitus (DM), which had started 14.5 years previously, on average, and 20% had neuropathies. After 18 months, there was no change in the frequency of lesions in diabetes target organs (p = 1.000) or in the neuropathy rate (p = 1.000). However, there were significant improvements in neuropathic symptoms, from 70% to 36.7% (p = 0.035), and in peripheral arterial disease, from 73.3% to 46.7% (p = 0.021). There was also a decrease in ulcers from 13.3% to 10% (p = 1.000).ConclusionsCreation of specialized outpatient clinics for prevention of diabetic foot is a viable investment, which has low cost compared with the high costs generated through the complications from this disease. This approach noticeably improves the patients’ quality of life, with reduction of morbidity.

Pé diabético. Parte 1: Úlceras e Infecções*

“…The prevention and treatment of DFU constitutes one of the major concerns in the care of diabetic patients. 4 Even when all preventive measures are properly adopted, the annual incidence of DFU reaches up to 2.2%. 5 Infections occur in up to 58% of patients who have a new DFU and, as a result, ∼ 5% of these patients will undergo a major amputation within 1 year.…”

“…A prevenção e o tratamento da UPP constitui uma das maiores preocupações no cuidado com os pacientes diabéticos. 4 Mesmo quando todos os cuidados preventivos são adequadamente adotados, a incidência anual de aparecimento de UPP atinge um índice aproximado de 2,2%. 5 Infecções ocorrem em até 58% dos pacientes que apresentam uma nova UPP e, em decorrência, ∼ 5% destes pacientes sofrerão uma amputação maior no prazo de até 1 ano.…”

Retrospective Evaluation of Twenty Seven Patients with Diabetic Foot Infection

“…Diyabetin en sık komplikasyonlarından biri olan diyabetik ayak enfeksiyonu (DAE) tüm dünyada olduğu gibi ülkemizde de hastaneye yatışların ve diyabetik olgulardaki non-travmatik ayak ampütasyonlarının önemli bir sebebidir (1)(2)(3). DAE; immün sistem bozukluğunun bulunduğu kişide dış travma, biyomekanik streste artış, periferik nöropati ve damar hastalığına sekonder iskemi Diyabetik Ayak Enfeksiyonlu Yirmi Yedi Olgunun Retrospektif Olarak Değerlendirilmesi Bu çalışma 3.…”