Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

Yun, Jae‐Seung; Cha, Seon-Ah; Lim, Tae-Seok; Lee, Eun-Young; Song, Ki‐Ho; Ahn, Yu‐Bae; Yoo, Ki‐Dong; Kim, Joon-Sung; Park, Young Jun; Ko, Seung‐Hyun

doi:10.1097/md.0000000000003128

Cited by 24 publications

(15 citation statements)

References 44 publications

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“…Various studies have also reported the average age of patients with DFU as between 40-55 years. 19,21,23 There is no significant reason for DFU incidence in middle-age persons but this can be due to the higher prevalence of diabetes in middle-age than in other age groups. In addition, although the quality of diabetes care in women appears to be higher than in men, the prevalence of DFU in women is higher than in men, which may be due to cultural differences in access to healthcare.…”

Section: Discussionmentioning

confidence: 99%

<p>Evaluation of Factors Affecting the Severity of Diabetic Foot Ulcer in Patients with Diabetes Referred to a Diabetes Centre in Kermanshah</p>

Ghobadi

Sarbarzeh

Jalilian

et al. 2020

DMSO

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Introduction: Diabetes mellitus is a metabolic disease characterized by high blood sugar (BS) levels and the change in the metabolism of lipids, carbohydrates, and insulin resistance, and is one of the main causes of disability and mortality worldwide. Among the different types of complications, which have many negative effects on personal and social life, diabetic foot ulcer (DFU) is very important. This study aims to investigate the factors affecting the severity of DFU among patients with diabetes. Methods: The study participants included 190 diabetic patients with a diagnosis of DFU. Data were collected using a two-part questionnaire for self-care awareness and functions in diabetic patients and Wagner's scale. The questionnaire was answered in cooperation with patients and the Wagner's score was estimated by a wound supervisor in the diabetes center. Results: There was 109 women (57.4%). Twenty-six patients had other diabetic complications as well as DFU. The average score of awareness in patients was 6.99±2.76 and the function was 62.22±9.92. The results found a direct relation between the age and the duration of illness with the score of the patient's awareness (P=0.008, P=0.000). There was also a direct relation between the level of education with score of awareness and the score of function in self-care (P=0.000, P=0.000), but the statistical results did not find any relation between awareness and the function in self-care of patients with the severity of DFU (P>0.05). Discussion: There was no relation between the self-care awareness and function with severity of DFU (P>0.05) that can be due to the more relation between DFU severity with hygiene and physical factors after the disease and the effect of awareness and function would be only in the incidence of the DFU. Conclusion: Awareness and function of patients in self-care is less than average. Increasing awareness of patients and empowering them through appropriate training can be effective in preventing diabetic foot ulcers.

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Section: Discussionmentioning

confidence: 99%

<p>Evaluation of Factors Affecting the Severity of Diabetic Foot Ulcer in Patients with Diabetes Referred to a Diabetes Centre in Kermanshah</p>

Ghobadi

Sarbarzeh

Jalilian

et al. 2020

DMSO

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“…A study over 5 years of 595 patients with T2DM showed that the development of foot ulcers was independently associated with CAN after adjustment for possible confounding factors (normal vs definite CAN, HR 4.45, 95% CI 1.29–15.33) 94. In addition, a study by Chahal et al suggested that there may be an association between sudomotor dysfunction and peripheral artery disease, which can contribute to foot ulceration and lower-limb amputations 95.…”

Section: Clinical Manifestations and Consequences Of Canmentioning

confidence: 99%

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Fisher

Tahrani

2017

DMSO

111

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Cardiac autonomic neuropathy (CAN) is a common and often-underdiagnosed complication of diabetes mellitus (DM). CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease, and morbidity in patients with DM, but despite these significant consequences CAN often remains undiagnosed for a prolonged period. This is commonly due to the disease being asymptomatic until the later stages, as well as a lack of easily available screening strategies. In this article, we review the latest developments in the epidemiology, pathogenesis, diagnosis, consequences, and treatments of CAN in patients with DM.

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“…29,30 Those with cardiovascular autonomic neuropathy were more likely to also have worse motor and sensory nerve function, 31 diabetic peripheral neuropathy, 28 and were more likely to develop diabetic foot ulcers. 32 Additionally, increasing severity of cardiovascular autonomic neuropathy has been linked to a higher prevalence of peripheral neuropathy. 33,34 However, the relationship between sensorimotor and cardiovascular autonomic function is largely unexplored in general populations of older adults, and examining this relationship was the aim of our study.…”

Section: Introductionmentioning

confidence: 99%

Relationship between sensorimotor peripheral nerve function and indicators of cardiovascular autonomic function in older adults from the Health, Aging and Body Composition Study

Lange‐Maia

Newman

Jakicic

et al. 2017

Experimental Gerontology

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Background Age-related peripheral nervous system (PNS) impairments are highly prevalent in older adults. Although sensorimotor and cardiovascular autonomic function have been shown to be related in persons with diabetes, the nature of the relationship in general community-dwelling older adult populations is unknown. Methods Health, Aging and Body Composition participants (n=2,399, age=76.5±2.9 years, 52% women, 38% black) underwent peripheral nerve testing at the 2000/01 clinic visit. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower-extremity peripheral neuropathy were collected by self-report. Cardiovascular autonomic function indicators included postural hypotension, resting heart rate (HR), as well as HR response to and recovery from submaximal exercise testing (400m walk). Multivariable modeling adjusted for demographic/lifestyle factors, medication use and comorbid conditions. Results In fully adjusted models, poor motor nerve conduction velocity (<40 m/sec) was associated with greater odds of postural hypotension, (OR=1.6, 95% CI: 1.0–2.5), while poor motor amplitude (<1 mV) was associated with 2.3 beats/min (p=0.003) higher resting HR. No associations were observed between sensory nerve function or symptoms of peripheral neuropathy and indicators of cardiovascular autonomic function. Conclusions Motor nerve function and indicators cardiovascular autonomic function remained significantly related even after considering many potentially shared risk factors. Future studies should investigate common underlying processes for developing multiple PNS impairments in older adults.

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Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

Cited by 24 publications

References 44 publications

<p>Evaluation of Factors Affecting the Severity of Diabetic Foot Ulcer in Patients with Diabetes Referred to a Diabetes Centre in Kermanshah</p>

<p>Evaluation of Factors Affecting the Severity of Diabetic Foot Ulcer in Patients with Diabetes Referred to a Diabetes Centre in Kermanshah</p>

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Relationship between sensorimotor peripheral nerve function and indicators of cardiovascular autonomic function in older adults from the Health, Aging and Body Composition Study

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