Assessing the State of Blood Supply of Lower Extremities in Patients with Diabetic Peripheral Polyneuropathy without Lesions of Main Arteries

M.B. Gorobeiko

Abstract


The study involved 178 patients with diabetes mellitus type 2 and symptoms of severe diabetic peripheral polyneuropathy. Transcutaneous partial oxygen pressure (PtcO2) in tissues of the feet was reduced compared with the norm in 139 (78 %) patients. We have obtained a direct statistically significant dependence of the degree of tissue ischemia of the lower extremities on the duration of diabetes mellitus, with the worst PtcO2 parameters in patients with diabetes duration more than 12 years. The level of tissue ischemia was independent of sex of the patients, smoking status and degree of diabetes mellitus compensation in terms of glycated hemoglobin. Due to the lack of instrumentally confirmed occlusion of the leg arteries of large and medium caliber we have concluded that the causes of hidden ischemia of the feet are microangiopathy and polyneuropathy.


Keywords


diabetes mellitus; neuropathy; microangiopathy; diagnosis

References


Davies M., Brophy S., Williams R., Taylor A. The Prevalence, Severity, and Impact of Painful Diabetic Peripheral Neuropathy in Type 2 Diabetes // Diabetes Care. — 2006. — Vol. 29. — P. 1518-1522.

Boulton A.J.M., Connor H., Cavanagh P.R. The foot in diabetes. — Chichester: J. Willey & Sons, 1994. — 256 p.

Brownlee M. Negative consequences of glycation // Metabolism. — 2000. — Vol. 49, Suppl. 2. — P. 9-13.

Cameron N.E., Cotter M.A. The relationship of vascular changes to metabolic factors in diabetes mellitus and their role in development of peripheral nerve complications // Diab. Metab. Rev. — 1994. — Vol. 10, № 3. — P. 189-224.

Gershater M.A., Löndahl M., Nyberg P. et al. Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study // Diabetologia. — 2009. — Vol. 52, № 3. — P. 398-407.

Таран Є.В., Бабіна Г.В., Горобейко М.Б., Гирявенко О.Я., Болгарська С.В. Парціальний тиск кисню у шкірі стоп хворих на цукровий діабет, ускладений периферичною нейропатією та мікроангіопатією // Клінічна ендокринологія та ендокринна хірургія. — 2007. — № 1(18). — C. 49-50.

Гурьева И.В. Профилактика, лечение, медико-социальная реабилитация и организация междисциплинарной помощи больным с синдромом диабетической стопы: Дис... д-ра мед. наук. — М., 2001.

Светухин А.М., Земляной А.Б. Гнойно-некротические формы синдрома диабетической стопы // Consilium medicum. — 2002. — Т. 4, № 10.

Бегма А.Н., Бегма И.В., Демин Д.И., Поташов Д.А., Гурьева И.В., Земляной А.Б. Оптимизация лечения нейроишемической формы синдрома диабетической стопы // Здравоохранение Урала. — 2003. — № 9.

Diabetic Foot Problems: Inpatient Management of Diabetic Foot Problems // NICE Clinical Guidelines, No. 119. — March, 2011. — 574 p. — online access http://www.ncbi.nlm.nih.gov/books/NBK82350/pdf/TOC.pdf.




DOI: https://doi.org/10.22141/2224-0586.5.60.2014.83511

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru